title: Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.
abstract: BACKGROUND
  Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed.
  
  
  METHODS
  Prospective 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.
  
  
  RESULTS
  250 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%).
  
  
  CONCLUSIONS
  14-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.
authors.affiliation: 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.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: University Hospital, Seconda University of Naples, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
authors.affiliation: Hospital San Pedro de Alcantara, Caceres, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-Infante
authors.affiliation: Hospital General de Tomelloso, Ciudad Real, Spain.
authors.forename: Alfredo J
authors.initials: AJ
authors.lastname: Lucendo
authors.affiliation: General Hospital Valencia, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Medina
authors.affiliation: Consorci Sanitari de Terrassa, Barcelona, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Modolell
authors.affiliation: Hospital Vírgen Macarena, Seville, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Tellez
authors.affiliation: Hospital Quirón Sagrado Corazón, Seville, Spain.
authors.forename: Blas
authors.initials: B
authors.lastname: Gomez
authors.affiliation: Hospital Río Hortega, Valladolid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Barrio
authors.affiliation: Hospital Quirón, Marbella, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: Perona
authors.affiliation: Hospital La Fe, Valencia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ortuño
authors.affiliation: Hospital Lozano Blesa, Zaragoza, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Ariño
authors.affiliation: Hospital Clínico de Santiago, Santiago de Compostela, Spain.
authors.forename: Juan Enrique
authors.initials: JE
authors.lastname: Domínguez-Muñoz
authors.affiliation: Agencia Sanitaria Costa del Sol, Malaga, Spain.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Perez-Aisa
authors.affiliation: Hospital Fuenlabrada, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bermejo
authors.affiliation: Hospital Alto Guadalquivir, Jaen, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Domínguez
authors.affiliation: Hospital Castellón, Castellón, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Almela
authors.affiliation: Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Gomez-Camarero
authors.affiliation: Hospital Miguel Servet, Zaragoza, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Millastre
authors.affiliation: Hospital Carmen y Severo Ochoa, Asturias, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Martin-Noguerol
authors.affiliation: Hospital "Immacolata", Sapri, Italy.
authors.forename: Antonietta G
authors.initials: AG
authors.lastname: Gravina
authors.affiliation: Hospital "Immacolata", Sapri, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Martorano
authors.affiliation: University Hospital, Seconda University of Naples, Naples, Italy.
authors.forename: Agnese
authors.initials: A
authors.lastname: Miranda
authors.affiliation: University Hospital, Seconda University of Naples, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.affiliation: Hospital San Pedro de Alcantara, Caceres, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Fernandez-Bermejo
authors.affiliation: Hospital General de Tomelloso, Ciudad Real, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Angueira
authors.affiliation: General Hospital Valencia, Valencia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Ferrer-Barcelo
authors.affiliation: Agencia Sanitaria Costa del Sol, Malaga, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Fernández
authors.affiliation: Univeristy Hospital La Princesa, Instituto de Investigación Sanitaria Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Spain.
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Marín
authors.affiliation: Univeristy Hospital La Princesa, Instituto de Investigación Sanitaria Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Spain.
authors.forename: Adrián G
authors.initials: AG
authors.lastname: McNicholl
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001944:Breath Tests; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D019233:Retreatment; D017211:Treatment Failure; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D014508:Urea; D064098:Esomeprazole; D000077266:Moxifloxacin
keywords: Eradication; Failure; Helicobacter pylori; Levofloxacin; Moxifloxacin; Quinolones; Rescue; Therapy