title: 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.
abstract: OBJECTIVE
  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 (13)C-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.
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Seong Tae
authors: ST
authors: Lee
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Dong Ho
authors: DH
authors: Lee
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Ji Hyun
authors: JH
authors: Lim
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Nayoung
authors: N
authors: Kim
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Young Soo
authors: YS
authors: Park
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Cheol Min
authors: CM
authors: Shin
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Hyun Jin
authors: HJ
authors: Jo
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: In Sung
authors: IS
authors: Song
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000863:Antacids / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001729:Bismuth / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D000077266:Moxifloxacin; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D013752:Tetracycline / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000863:Antacids; D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D013752:Tetracycline; D001729:Bismuth; D000077266:Moxifloxacin
keywords: Bismuth-containing quadruple regimen; Helicobacter pylori; Moxifloxacin-based triple regimen; Second-line therapy