Discussion
H.pylori, community-acquired pneumonia, H.Pylori
COMMUNITY-ACQUIRED PNEUMONIA
In this work, we demonstrated that the levofloxacin-based regimen resulted in a 74.36% eradication rate while the clarithromycin-based regimen showed a 64.66% eradication rate based on PP. Lower eradication rates were reported based on the ITT analysis (64.44%) for levofloxacin-based regimen and 55.56% for clarithromycin-based regimen. Both regimens had an unacceptable rate of eradication. While the eradication rate using levofloxacin was higher than that of the clarithromycin-based regimen, the difference did not reach statistical significance. Moreover, the eradication rate in the levofloxacin group was lower than expected.Clarithromycin-based regimen’s eradication rate was 84% in a study performed in Newyork over patients treated between 2011 and 2017 [Previously Elantouny et al. [During the COVID-19 pandemic, drug repurposing of on-market FDA-approved drugs was suggested to be more efficient and cost-effective compared to de novo drug discovery [It has been shown that antibiotic resistance could be acquired via different mechanisms. Azithromycin was suggested to have a special role for community treatment of suspected COVID-19 due to its antiviral, anti-inflammatory, and immunomodulatory properties. Given its safety profile, low cost and oral route of administration, Azithromycin is a frequently used antimicrobial agent during the pandemic [Respiratory fluoroquinolones have also been recommended in the treatment of community-acquired pneumonia in COVID-19 patients. Because of their potential antiviral activity and immunomodulatory properties, the use of respiratory fluoroquinolones in the treatment of SARS-CoV-2 was suggested [Clarithromycin-based triple therapy is still considered a drug of choice to treat Strengths in our study include that it is the first one to address the problem of increasing H.pylori resistance after the COVID-19 pandemic. Limitations of our study include that both patients and care providers were not blinded. H.Pylori detection tools were not uniform, but this was to enable us to enrol more patients to the study. To overcome this limitation, the same detection method was reused to assess the treatment outcome including reendoscopy if needed aiming for less bias. All used methods have high and comparable sensitivity, specificity, and accuracy with negative predictive values above 90% [