title: High Helicobacter pylori cure rate with sitafloxacin-based triple therapy.
abstract: BACKGROUND
  Bacterial resistance of Helicobacter pylori to antibiotics is increasing and it often leads to failure of antibiotic treatment. A new sitafloxacin-based triple therapy was developed to counter this situation; the fluoroquinolone sitafloxacin has a low minimum inhibitory concentration for H. pylori.
  
  
  OBJECTIVE
  To investigate the efficacy in Japanese patients of sitafloxacin-based triple therapy and document its efficacy in relation to anti-microbial susceptibility.
  
  
  METHODS
  We investigated the efficacy of a 1-week sitafloxicin-based regimen of rabeprazole 10 mg four times daily (q.d.s.), metronidazole 250 mg twice daily (b.d.) and sitafloxacin 100 mg b.d. in 180 H. pylori-positive Japanese patients (first-line treatment: n = 45, second-line; n = 41, third-line: n = 94). At 8 weeks, patients were given the (13) C-urea breath test to assess eradication status.
  
  
  RESULTS
  Eradication rate was 92.2% [95% confidence interval (CI): 87.3-95.7%, 166/180] in intention-to-treat analysis. Although the eradication rate was higher in patients treated with first-line therapy [45/45 (100%, 95% CI: 83.4-100%)] than in those with second- [38/41 (92.7%, 80.1-98.5%)] or third-line therapy [83/94 (88.3%, 80.0-94.0%)], no significant differences were noted with respect to the number of previous therapy attempts (P = 0.054). Eradication rates in patients infected with sensitive- and resistant strains to metronidazole were 96.6% (28/29) and 96.3% (77/80) (P = 0.941), respectively, while rates were 98.4% (60/61) in sitafloxacin-sensitive and 50.0% (1/2) in sitafloxacin resistant strains (P < 0.001).
  
  
  CONCLUSIONS
  Sitofloxacin-based triple therapy with metronidazole b.d. and rabeprazole q.d.s. achieved an eradication rate exceeding 88%, irrespective of eradication history, CYP2C19 genotype, or metronidazole resistance status.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.|Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Shiga, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sahara
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ichikawa
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kagami
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Uotani
authors.affiliation: Center for Clinical Research, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Furuta
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001944:Breath Tests; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D064750:Rabeprazole / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D008795:Metronidazole; D064750:Rabeprazole; C076246:sitafloxacin