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Dig Liver Dis. 2015 Feb;47(2):108-13. doi: 10.1016/j.dld.2014.10.009. Epub 2014 Nov 11.

Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.

Author information

1
Univeristy Hospital La Princesa, Instituto de Investigación Sanitaria Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Spain. Electronic address: javier.p.gisbert@gmail.com.
2
University Hospital, Seconda University of Naples, Naples, Italy.
3
Hospital San Pedro de Alcantara, Caceres, Spain.
4
Hospital General de Tomelloso, Ciudad Real, Spain.
5
General Hospital Valencia, Valencia, Spain.
6
Consorci Sanitari de Terrassa, Barcelona, Spain.
7
Hospital Vírgen Macarena, Seville, Spain.
8
Hospital Quirón Sagrado Corazón, Seville, Spain.
9
Hospital Río Hortega, Valladolid, Spain.
10
Hospital Quirón, Marbella, Spain.
11
Hospital La Fe, Valencia, Spain.
12
Hospital Lozano Blesa, Zaragoza, Spain.
13
Hospital Clínico de Santiago, Santiago de Compostela, Spain.
14
Agencia Sanitaria Costa del Sol, Malaga, Spain.
15
Hospital Fuenlabrada, Madrid, Spain.
16
Hospital Alto Guadalquivir, Jaen, Spain.
17
Hospital Castellón, Castellón, Spain.
18
Hospital Gregorio Marañón, Madrid, Spain.
19
Hospital Miguel Servet, Zaragoza, Spain.
20
Hospital Carmen y Severo Ochoa, Asturias, Spain.
21
Hospital "Immacolata", Sapri, Italy.
22
Univeristy Hospital La Princesa, Instituto de Investigación Sanitaria Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Spain.

Abstract

BACKGROUND:

Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed.

METHODS:

Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40 mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes.

RESULTS:

250 patients were consecutively included (mean age 48 ± 15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n = 179), sequential (n = 27), and concomitant (n = 44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR = 0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%).

CONCLUSION:

14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen.

KEYWORDS:

Eradication; Failure; Helicobacter pylori; Levofloxacin; Moxifloxacin; Quinolones; Rescue; Therapy

PMID:
25454706
DOI:
10.1016/j.dld.2014.10.009
[Indexed for MEDLINE]
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