title: Bismuth-based quadruple therapy modified with moxifloxacin for Helicobacter pylori eradication.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy, tolerability and safety of modified bismuth-based quadruple therapy for the second-line eradication treatment of Helicobacter pylori (H. pylori) infection.
  
  
  METHODS
  Out of 758 patients treated between January 2010 and December 2015, 155 patients (20.45%) remained H. pylori positive after the first line treatment and received the second-line treatment consisting of colloidal bismuth subcitrate (240 mg twice daily), pantoprazole (40 mg twice daily), metronidazole (500 mg twice daily) and moxifloxacin (400 mg once daily) for 14 days. Six weeks after the completion of treatment patients were retested for the presence of H. pylori infection with 13C urea breath test.
  
  
  RESULTS
  Out of 155 patients, 142 patients completed their second-line regimens. 13 patients were excluded from the study: 4 experienced adverse effects that have led to discontinuation of treatment, 5 were lost to follow-up and 4 complied poorly with medication. The eradication rates were 80.64% (125/155) and 88.02% (125/142) according to intention-to-treat and per-protocol analyses. Compliance with the therapy was 89%.
  
  
  CONCLUSIONS
  Moxifloxacin in modified bismuth-based quadruple therapy was found to be effective and safe with good drug compliance; therefore it may be an acceptable alternative to other second-line eradication protocols.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University Hospital Sveti Duh, Zagreb, Croatia.|Faculty of Health Studies, School of Medicine, University of Osijek, Osijek, Croatia.
authors.forename: Marinko
authors.initials: M
authors.lastname: Marušić
authors.affiliation: Children's Hospital, Zagreb, Croatia.
authors.forename: Lucija
authors.initials: L
authors.lastname: Dominković
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University Hospital Sveti Duh, Zagreb, Croatia.
authors.forename: Karolina
authors.initials: K
authors.lastname: Majstorović Barać
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University Hospital Sveti Duh, Zagreb, Croatia - sasa.gulic@yahoo.com.
authors.forename: Saša
authors.initials: S
authors.lastname: Gulić
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University Hospital Sveti Duh, Zagreb, Croatia.
authors.forename: Josip
authors.initials: J
authors.lastname: Bago
authors.affiliation: Department of Internal Medicine, General Hospital, Vinkovci, Croatia.
authors.forename: Davorin
authors.initials: D
authors.lastname: Pezerović
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001944:Breath Tests; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D000077266:Moxifloxacin; D009942:Organometallic Compounds / Q000627:therapeutic use*; D000077402:Pantoprazole; D010349:Patient Compliance; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000077402:Pantoprazole; C002791:bismuth tripotassium dicitrate; D000077266:Moxifloxacin