Gut Liver.  2014 Nov;8(6):605-611. 10.5009/gnl13303.

The Efficacy of Moxifloxacin-Containing Triple Therapy after Standard Triple, Sequential, or Concomitant Therapy Failure for Helicobacter pylori Eradication in Korea

Affiliations
  • 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. dhljohn@snubh.org

Abstract

BACKGROUND/AIMS
Retreatment after initial treatment failure for Helicobacter pylori is very challenging. The purpose of this study was to evaluate the efficacies of moxifloxacin-containing triple and bismuth-containing quadruple therapy.
METHODS
A total of 151 patients, who failed initial H. pylori treatment, were included in this retrospective cohort study. The initial regimens were standard triple, sequential, or concomitant therapy, and the efficacies of the two following second-line treatments were evaluated: 7-day moxifloxacin-containing triple therapy (rabeprazole 20 mg twice a day, amoxicillin 1,000 mg twice a day, and moxifloxacin 400 mg once daily) and 7-day bismuth-containing quadruple therapy (rabeprazole 20 mg twice a day, tetracycline 500 mg 4 times a day, metronidazole 500 mg 3 times a day, and tripotassium dicitrate bismuthate 300 mg 4 times a day).
RESULTS
The overall eradication rates after moxifloxacin-containing triple therapy and bismuth-containing quadruple therapy were 69/110 (62.7%) and 32/41 (78%), respectively. Comparison of the two regimens was performed in the patients who failed standard triple therapy, and the results revealed eradication rates of 14/28 (50%) and 32/41 (78%), respectively (p=0.015). The frequency of noncompliance was not different between the two groups, and there were fewer adverse effects in the moxifloxacin-containing triple therapy group (2.8% vs 7.3%, p=0.204 and 25.7% vs 43.9%, p=0.031, respectively).
CONCLUSIONS
Moxifloxacin-containing triple therapy, a recommended second-line treatment for initial concomitant or sequential therapy failure, had insufficient efficacy.

Keyword

Anti-bacterial agents; Helicobacter pylori; Moxifloxacin; Salvage therapy

MeSH Terms

Aged
Amoxicillin/*therapeutic use
Anti-Bacterial Agents/*therapeutic use
Anti-Ulcer Agents/*therapeutic use
Breath Tests
Cohort Studies
Drug Therapy, Combination
Female
Fluoroquinolones/*therapeutic use
Gastroesophageal Reflux/complications
Helicobacter Infections/complications/*drug therapy/pathology
Helicobacter pylori
Humans
Male
Metronidazole/*therapeutic use
Middle Aged
Organometallic Compounds/*therapeutic use
Peptic Ulcer/complications
Rabeprazole/*therapeutic use
Republic of Korea
Retrospective Studies
Salvage Therapy
Stomach/pathology
Tetracycline/*therapeutic use
Treatment Failure
Treatment Outcome
Urea/analysis
Amoxicillin
Anti-Bacterial Agents
Anti-Ulcer Agents
Fluoroquinolones
Organometallic Compounds
Metronidazole
Rabeprazole
Tetracycline
Urea
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