Helicobacter pylori Eradication in the Era of Rising Antibiotic Resistance: A Randomized Controlled Comparison of Clarithromycin- and Levofloxacin-Based Triple Therapy with or without Lactoferrin
Abstract
Background: Helicobacter pylori infection affects nearly half of the global population and is a major cause of peptic ulcer disease and gastric cancer. Increasing antibiotic resistance, particularly to clarithromycin, has reduced the efficacy of standard triple therapy, necessitating evaluation of alternative regimens and adjunctive therapies.
Objectives: To compare the eradication rates and safety of clarithromycin- and levofloxacin-based triple therapy, with and without adjunctive lactoferrin.
Methods: In this randomized, open-label, 2 × 2 factorial trial, 160 adult patients with confirmed H. pylori infection were allocated equally into four groups: clarithromycin-based triple therapy, levofloxacin-based triple therapy, and each regimen combined with lactoferrin. Treatments were administered for 14 days. Eradication was assessed using stool antigen testing four weeks after therapy. Analysis was performed according to the intention-to-treat principle.
Results: Eradication rates were 72.5% in both the clarithromycin and levofloxacin groups, compared with 90.0% and 97.5% in the corresponding lactoferrin-supplemented groups, respectively (p = 0.003). Lactoferrin significantly improved eradication rates (72.5% vs. 93.8%, p < 0.001). No significant difference was observed between antibiotic regimens alone (p = 0.673). Adverse events were mild and comparable across groups.
Conclusion: Adjunctive lactoferrin significantly enhances H. pylori eradication rates when combined with…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 160 participants or records.
Read the paper
Related studies
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Propranolol, chlorpromazine and diclofenac restore susceptibility of extensively drug-resistant (XDR)-Acinetobacter baumannii to fluoroquinolones
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.