Gut Liver.  2015 Jul;9(4):478-485. 10.5009/gnl14020.

Efficacy of 7-Day and 14-Day Bismuth-Containing Quadruple Therapy and 7-Day and 14-Day Moxifloxacin-Based Triple Therapy as Second-Line Eradication for Helicobacter pylori Infection

• Lee ST
• Lee DH
• Lim JH
• Kim N
• Park YS
• Shin CM
• Jo HJ
• Song IS

• KMID: 2160631
• DOI: http://doi.org/10.5009/gnl14020

Abstract

BACKGROUND/AIMS
Bismuth-containing quadruple and moxifloxacin-based triple regimens are recommended as second-line therapy for Helicobacter pylori infection. The aim of this study was to compare the efficacy of each regimen.
METHODS
From August 2004 to October 2012, a total of 949 patients (mean age, 54.32+/-12.08 years; male, 49.4%) who failed H. pylori eradication with a standard triple regimen were included. Patients treated with a bismuth-containing quadruple regimen for 7 and 14 days were designated as 7-BMT and 14-BMT, respectively, and those treated with a moxifloxacin-based triple regimen for 7 and 14 days were designated as 7-MA and 14-MA, respectively. H. pylori eradication was confirmed using the 13C-urea breath test, rapid urease test or histology.
RESULTS
The eradication rates by 7-BMT, 14-BMT, 7-MA, and 14-MA were 66.4% (290/437), 71.1% (113/159), 53.1% (51/96), and 73.5% (189/257), respectively, by intention-to-treat analysis (ITT) and 76.5% (284/371), 83.8% (109/130), 55.6% (50/90), and 80.6% (187/232), respectively, by per-protocol analysis (PP). The eradication rates were higher in 14-BMT than 7-BMT by the ITT and PP analyses (p=0.277 and p=0.082, respectively). The 14-BMT and 14-MA treatments showed similar efficacies by ITT and PP (p=0.583 and p=0.443, respectively).
CONCLUSIONS
The 7-BMT, 14-BMT, and 14-MA treatments showed similar and suboptimal efficacies. In both regimens, extending the duration of treatment may be reasonable considering the high level of antibiotic resistance in Korea.

Keyword

Helicobacter pylori; Second-line therapy; Bismuth-containing quadruple regimen; Moxifloxacin-based triple regimen

MeSH Terms

Adult
Aged
Amoxicillin/administration & dosage
Antacids/*administration & dosage
Anti-Infective Agents/*administration & dosage
Bismuth/*administration & dosage
Drug Administration Schedule
Drug Therapy, Combination/methods
Female
Fluoroquinolones/*administration & dosage
Helicobacter Infections/*drug therapy
*Helicobacter pylori
Humans
Intention to Treat Analysis
Male
Metronidazole/administration & dosage
Middle Aged
Proton Pump Inhibitors/administration & dosage
Retrospective Studies
Tetracycline/administration & dosage
Treatment Outcome
Amoxicillin
Antacids
Anti-Infective Agents
Bismuth
Fluoroquinolones
Proton Pump Inhibitors
Metronidazole
Tetracycline