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.
- Author:
Seong Tae LEE
1
;
Dong Ho LEE
;
Ji Hyun LIM
;
Nayoung KIM
;
Young Soo PARK
;
Cheol Min SHIN
;
Hyun Jin JO
;
In Sung SONG
Author Information
- Publication Type:Original Article ; Comparative Study
- Keywords: Helicobacter pylori; Second-line therapy; Bismuth-containing quadruple regimen; Moxifloxacin-based triple regimen
- MeSH: 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
- From:Gut and Liver 2015;9(4):478-485
- CountryRepublic of Korea
- Language:English
- 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.
