84 consecutive patients with dyspeptic symptoms and proven H. pylori infection by either UBT or upper endoscopy with biopsies were enrolled. Patients received a 10-day sequential therapy with lansoprazole 30 mg plus amoxycillin 1 g (all twice daily) for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg (all twice daily) for the remaining 5 days. Eradication failure patients received triple therapy with lansoprazole 30 mg, levofloxacin 250 mg, and amoxycillin 1 g (all twice daily) for 10 days.
Following the sequential therapy H. pylori eradication was achieved in 70/84 (83.3 % ; 95 % CI = 75.4–91.3) patients, and in 70/77 (90.9 % ; 95 % CI = 84.5–97.3) patients at ITT and PP analyses, respectively. The infection was cured in all 7 eradication failure patients by using second-line therapy.
A sequential regimen as first-line therapy and a 10-day levofloxacin-based triple regimen in those patients who failed to clear the infection, appear to be a valid therapeutic strategy for management of H. pylori infection in clinical practice.