Retrospective Comparison of Conventional Triple Therapy and Levofloxacin-Based Sequential Therapy for Helicobacter pylori Eradication in Mardan Medical Complex

Q: What was the objective of this retrospective study?

The study aimed to compare clearance proportions of conventional triple therapy versus levofloxacin-based sequential therapy using record-based data from patients treated at Mardan Medical Complex.

Q: How were patients selected and what confirmed the Helicobacter pylori infection?

Adults aged 18 to 65 with stool antigen-confirmed H. pylori infection were included based on consecutive sampling of eligible patients treated during January to June 2024.

Q: Which treatment regimen showed higher eradication and when was success assessed?

Sequential therapy showed higher clearance (80%) than triple therapy (62%). Eradication was confirmed by a stool antigen test four weeks after treatment completion.

Sep 30, 2026

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Objective: Compare, using record-based data, clearance proportions of conventional triple therapy versus levofloxacin-based sequential therapy among patients treated at Mardan Medical Complex. Methods: Record review from January to June 2024 included adults aged 18–65 with stool antigen-confirmed Helicobacter pylori infection; demographics, regimens, and post-treatment stool antigen results were analyzed with chi-square and independent t-tests (p < 0.05). Results: Among 238 patients, clearance was 62% with triple therapy and 80% with sequential therapy (χ²=9.03, p=0.003). Conclusion: Sequential therapy achieved superior eradication and better tolerance, especially where clarithromycin resistance is high.

LanguageEnglish

CategoryHealthcare

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Pages5

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Review began 11/12/2025 Review ended 11/28/2025 Published 12/09/2025 © Copyright 2025 Naeem et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98803 Open Access Original Article Retrospective Comparison of Conventional Triple Therapy and Levofloxacin-Based Sequential Therapy for Helicobacter pylori Eradication in Mardan Medical Complex M Naeem 1, Manzoor Hussain 2 1. Gastroenterology, Mardan Medical Complex, Mardan, PAK 2. General Medicine, Mardan Medical Complex, Mardan, PAK Corresponding author: Manzoor Hussain, [drmanzoorlrh@gmail.com](drmanzoorlrh@gmail.com) Abstract Objective: This study aims to compare, using record-based data, the clearance proportions of the conventional triple management regimen and the levofloxacin-based sequential management regimen inpatients treated at Mardan Medical Complex. Methods: A record-based review was conducted from January to June 2024 among adults aged 18 to 65 years with stool antigen-confirmed Helicobacter pylori infection. Data were collected for demographics, management regimens, and post-management stool antigen results. Statistical analyses included Chi-square and independent t-tests (p < 0 .05 notable) . Results: Among 238 patients, clearance was obtained in 62% of those receiving the triple management regimen and 80% of those receiving the sequential management regimen (χ² = 9 .03, p = 0 .003) . The sequential management regimen showed greater clearance and better tolerance. Conclusion: Sequential management regimen obtained superior clearance proportions and should be preferred in areas with high clarithromycin resistance. Categories: Internal Medicine, Gastroenterology Keywords: antibiotic resistance, dyspepsia, eradication rate, helicobacter pylori, levofloxacin, proton pump inhibitor, sequential therapy, triple therapy Introduction Helicobacter pylori is a Gram-negative bacterium that colonizes the human gastric mucosa and is a key factor in gastritis, peptic ulcer disease, and gastric carcinoma [1,2] . Globally, more than half of the population is infected, with greater prevalence in developing regions due to poor sanitation and overcrowding [3] . For several decades, the standard first-line management has been a clarithromycin-based triple management regimen comprising a proton pump inhibitor (PPI), clarithromycin, and amoxicillin [4] . However, the increasing resistance to clarithromycin has notably reduced clearance success proportions [5] . Levofloxacinbased sequential management regimen introduces antibiotic rotation within the same management course, potentially overcoming resistance mechanisms [6,7] . Given the limited regional data in Pakistan, this record-based analysis aimed to assess and compare the clearance proportions of triple and sequential regimens in real-world clinical practice. H. pylori colonization remains a notable global public health issue, contributing to chronic gastritis, peptic ulcer disease, and gastric malignancies. The rise in antimicrobial resistance, particularly to clarithromycin and metronidazole, has compromised the efficacy of standard regimens. Sequential regimens introduce a two-phase approach by varying antibiotic exposure during the same treatment course, which may help overcome resistance mechanisms and improve eradication rates. However, regional data on comparative effectiveness remain limited, emphasizing the need for localized studies like the present one. Global data have shown resistance rates rising across multiple regions, underscoring the need for alternative regimens [8,9] . Materials And Methods Study design A record-based observational analysis was conducted at the Department of Medicine, Mardan Medical Complex, and Bacha Khan Medical Colle

FAQs

What was the objective of this retrospective study?

The study aimed to compare clearance proportions of conventional triple therapy versus levofloxacin-based sequential therapy using record-based data from patients treated at Mardan Medical Complex.

How were patients selected and what confirmed the Helicobacter pylori infection?

Adults aged 18 to 65 with stool antigen-confirmed H. pylori infection were included based on consecutive sampling of eligible patients treated during January to June 2024.

Which treatment regimen showed higher eradication and when was success assessed?

Sequential therapy showed higher clearance (80%) than triple therapy (62%). Eradication was confirmed by a stool antigen test four weeks after treatment completion.

Sep 30, 2026

Uploaded by Blue Pony