Clarithromycin versus levofloxacin-based regimens for Helicobacter pylori eradication in the Kurdistan Region of Iraq: A randomized clinical trial

Helicobacter pylori infection is a predisposing factor for gastric cancer. This prospective, randomized clinical trial aimed to compare H. pylori eradication rates associated with a clarithromycin-based regimen and levofloxacin-based regimen. H. pylori infection was confirmed by a rapid urease test during endoscopy and its eradication by a urea breath test. In this study, 192 patients were recruited; 93 patients received a clarithromycin-based regimen and 99 a levofloxacin-based regimen. Sixty-four patients completed the clarithromycin-based regimen and 60 the levofloxacin-based regimen. The eradication success rate of the clarithromycin-based regimen was 52/64 (81.25%), while that of the levofloxacin-based regimen was 49/60 (81.6%) (P=0.9524; odds ratio [OR]=1.0280; confidence interval [CI]=0.4153-2.5447). Investigation of the risk factors associated with treatment failure showed that the overall efficacy of the regimens was influenced by body mass index (BMI), with a high failure rate observed in patients with a high BMI (P=0.0174; OR=1.1116; CI=1.0187-1.2129). Age, sex, endoscopic diagnosis and smoking did not influence treatment outcomes. Further studies are needed to monitor H. pylori antibiotic resistance rates.