Auttajaroon J, et al. – Via performing a prospective randomized pilot study, researchers assessed a new regimen consisting of once-daily rabeprazole (60 mg), levofloxacin (750 mg), long-acting clarithromycin-MR (1 g), and bismuth subsalicylate (1,048 mg) for 7 or 14 days. One hundred participants were randomized (mean age of 54 years). The investigators found that the eradication rates were: 94% and 84% with 14-day and 7-day therapy, respectively. Furthermore, the resistance rates were: 13.0% for clarithromycin, 26.0% for fluoroquinolone, 2.9% for dual clarithromycin-fluoroquinolone resistance, and 62.8% for metronidazole. In patients with levofloxacin susceptible strain, the 14-day regimen provided 100% eradication regardless of the presence of clarithromycin resistance. The high eradication rate given by once-daily 14-day rabeprazole-, levofloxacin-, clarithromycin-MR-, and bismuth-containing therapy indicated that triple therapies with a PPI, bismuth, and clarithromycin-MR or levofloxacin would be highly effective either as once-a-day tailored therapy or as first-line empiric therapy. CYP2C19 genotypes did not affect cure rates.