title: Moxifloxacin-based triple therapy versus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Moxifloxacin-based triple therapy has been suggested as an alternative first line therapy to clarithromycin-based triple therapy for Helicobacter pylori infection.
  
  
  OBJECTIVE
  To systematically review the efficacy and tolerance of moxifloxacin-based triple therapy, and to conduct a meta-analysis of studies comparing this regimen with clarithromycin-based triple therapy.
  
  
  METHODS
  A search of The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials comparing moxifloxacin-based triple therapy to gold standard triple therapy in the first-line treatment of Helicobacter pylori infection were selected for meta-analysis. Relative risk was used as a measure of the effect of the two above-mentioned regimens with a fixed-effects model using the methods of DerSimonian and Laird.
  
  
  RESULTS
  Four randomized controlled trials totaling 772 patients were included. The meta-analysis showed that the mean eradication rate was 84.1 (318/378) in the moxifloxacin-based triple therapy group and 73.6 (290/394) in the clarithromycin-based triple therapy group; there was statistical significance between the two groups (RR, 1.13; 95% CI, 1.01, 1.27; P=0.04). There were no statistically significant difference in the overall side effects (RR, 0.61; 95% CI, 0.25, 1.48; P<0.28).
  
  
  CONCLUSIONS
  Moxifloxacin-based triple therapy is more effective and does not increase the incidence of overall side effects compared to clarithromycin-based triple therapy in the treatment of H. pylori infection.
authors.affiliation: Evidence-Based Medicine Center of Lanzhou University, Lanzhou, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wenzhen
authors.forename: Yang
authors.initials: Y
authors.lastname: Kehu
authors.forename: Ma
authors.initials: M
authors.lastname: Bin
authors.forename: Li
authors.initials: L
authors.lastname: Yumin
authors.forename: Guan
authors.initials: G
authors.lastname: Quanlin
authors.forename: Wang
authors.initials: W
authors.lastname: Donghai
authors.forename: Yang
authors.initials: Y
authors.lastname: Lijuan
mesh_terms: D001372:Aza Compounds / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D000077266:Moxifloxacin; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D001372:Aza Compounds; D024841:Fluoroquinolones; D054328:Proton Pump Inhibitors; D011804:Quinolines; D008795:Metronidazole; D017291:Clarithromycin; D000077266:Moxifloxacin