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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

  • 1Univeristy 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.
  • 2University Hospital, Seconda University of Naples, Naples, Italy.
  • 3Hospital San Pedro de Alcantara, Caceres, Spain.
  • 4Hospital General de Tomelloso, Ciudad Real, Spain.
  • 5General Hospital Valencia, Valencia, Spain.
  • 6Consorci Sanitari de Terrassa, Barcelona, Spain.
  • 7Hospital Vírgen Macarena, Seville, Spain.
  • 8Hospital Quirón Sagrado Corazón, Seville, Spain.
  • 9Hospital Río Hortega, Valladolid, Spain.
  • 10Hospital Quirón, Marbella, Spain.
  • 11Hospital La Fe, Valencia, Spain.
  • 12Hospital Lozano Blesa, Zaragoza, Spain.
  • 13Hospital Clínico de Santiago, Santiago de Compostela, Spain.
  • 14Agencia Sanitaria Costa del Sol, Malaga, Spain.
  • 15Hospital Fuenlabrada, Madrid, Spain.
  • 16Hospital Alto Guadalquivir, Jaen, Spain.
  • 17Hospital Castellón, Castellón, Spain.
  • 18Hospital Gregorio Marañón, Madrid, Spain.
  • 19Hospital Miguel Servet, Zaragoza, Spain.
  • 20Hospital Carmen y Severo Ochoa, Asturias, Spain.
  • 21Hospital "Immacolata", Sapri, Italy.
  • 22Univeristy 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
[PubMed - indexed for MEDLINE]
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