Moxifloxacin-based strategies for first-line treatment of Helicobacter pylori infection.
BACKGROUND
Standard anti-Helicobacter pylori therapy may not achieve a satisfactory eradication rate. Fluoroquinolones, such as moxifloxacin, are safe and promising agents for H. pylori eradication.


OBJECTIVE
To compare the efficacy of two 1-week moxifloxacin-based H. pylori eradication regimens with two standard treatments.


METHODS
Three hundred and twenty H. pylori-positive subjects were randomized into four groups to receive: moxifloxacin, amoxicillin, esomeprazole (Group MAE); moxifloxacin, tinidazole and esomeprazole (Group MTE); standard triple therapies with clarithromycin, amoxicillin and esomeprazole (Group CAE) or tinidazole (Group CTE) for 7 days. H. pylori status was re-assessed 6 weeks after the end of therapy by 13C urea breath test.


RESULTS
Three hundred and twenty patients completed the efficacy analysis per protocol; H. pylori eradication rate in group MTE was 90% (72 of 80) and 92% (72 of 78), in group MAE was 88% (70 of 80) and 89%, (70 of 79) in Group CAE was 73% (58 of 80) and 78% (58 of 74), and in Group CTE was 75% (60 of 80) and 79% (60 of 76), respectively, in intention-to-treat and in per protocol analyses. Eradication rates of moxifloxacin-based triple therapies were significantly higher than that observed using standard triple schemes. The incidence of side effects was significantly lower in moxifloxacin groups than in control groups.


CONCLUSIONS
Seven-day moxifloxacin-based triple therapies provide optimal eradication rates with a good compliance when compared with the standard triple therapy schemes.
Nista
E C
EC
Department of Internal Medicine, Catholic University, Rome, Italy.
Candelli
M
M
Zocco
M A
MA
Cazzato
I A
IA
Cremonini
F
F
Ojetti
V
V
Santoro
M
M
Finizio
R
R
Pignataro
G
G
Cammarota
G
G
Gasbarrini
G
G
Gasbarrini
A
A
D000328:Adult; D000658:Amoxicillin / Q000009:adverse effects / Q000627:therapeutic use; D001372:Aza Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D004415:Dyspepsia / Q000382:microbiology; D064098:Esomeprazole / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D010349:Patient Compliance; D011446:Prospective Studies; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D014011:Tinidazole / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D014011:Tinidazole; D000658:Amoxicillin; D064098:Esomeprazole; D000077266:Moxifloxacin