• Dig Liver Dis · Feb 2015

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

    • Javier P Gisbert, Marco Romano, Javier Molina-Infante, Alfredo J Lucendo, Enrique Medina, Inés Modolell, Manuel Rodríguez-Tellez, Blas Gomez, Jesús Barrio, Monica Perona, Juan Ortuño, Inés Ariño, Juan Enrique Domínguez-Muñoz, Ángeles Perez-Aisa, Fernando Bermejo, Jose Luis Domínguez, Pedro Almela, Judith Gomez-Camarero, Judith Millastre, Elisa Martin-Noguerol, Antonietta G Gravina, Marco Martorano, Agnese Miranda, Alessandro Federico, Miguel Fernandez-Bermejo, Teresa Angueira, Luis Ferrer-Barcelo, Nuria Fernández, Alicia C Marín, and Adrián G McNicholl.
    • 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.
    • Dig Liver Dis. 2015 Feb 1; 47 (2): 108-13.

    BackgroundAim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed.MethodsProspective 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.Results250 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%).Conclusion14-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.Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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