The efficiency of Levofloxacin Containing Sequential Therapy with or without Bismuth, in Helicobacter Pylori Eradication, in Non-ulcer Dyspepsia

Introduction : The aim of this study is to determine the efficiency of levofloxacin containing sequential therapy with or without bismuth in Helicobacter pylori (Hp) eradication in nonulcer dyspepsia. Materials and Methods: One hundred and ninety Hp-positive patients with the pre-diagnosis of nonulcer dyspepsia were included in this study. Patients were randomized into 2 groups and 95 individuals were included in each group. The first group was administered levofloxacin containing sequential therapy with bismuth, whereas the second group was administered only levofloxacin containing sequential therapy. Rates of therapy discontinuation and eradication success were compared between the 2 groups. Furthermore, symptomatic healing rates were compared between patients in whom Hp eradication was achieved and in whom it was not achieved. Results : Ninety-one patients from each group applied for follow-up after treatment. It was found that 7/91(7.6%) patients from the first group and 5/91(5.4%) patients from the second group did not complete the therapy (p >0.05). In patients who completed therapy, Hp eradication was achieved in 72 out of the 84 patients (85.2%) from the first group and 71 out of 86 patients (82.6%) from the second group (p >0.05). In addition, symptomatic healing occurred in 125 out of 143 patients (87.4%) in whom Hp was eradicated and 12 out of 27 (44.4%) patients in whom Hp was not eradicated (p <0.001). Discussion : Levofloxacin containing sequential therapy for 14 days is quite effective and well-tolerated choice for Hp eradication. However, adding bismuth to sequential therapy does not significantly improve Hp eradication success rates. Therefore, Hp eradication is beneficial and necessary in patients with nonulcer dyspepsia.