Moxifloxacine Plus Amoxicillin and Ranitidine Bismuth Citrate or Esomeprazole Triple Therapies for Helicobacter pylori Infection

• Published in: Digestive diseases and sciences 2008-12, Vol.53 (12), p.3133-3137
• Main Authors: Kılıç, Zeki Mesut Yalın, Köksal, Aydın Şeref, Çakal, Başak, Nadir, Işılay, Özin, Yasemin Özderin, Kuran, Sedef, Şahin, Burhan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Amoxicillin - adverse effects; Amoxicillin - therapeutic use; Anti-Infective Agents - adverse effects; Anti-Infective Agents - therapeutic use; Anti-Ulcer Agents - adverse effects; Anti-Ulcer Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Aza Compounds - adverse effects; Aza Compounds - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biochemistry; Biological and medical sciences; Bismuth - adverse effects; Bismuth - therapeutic use; Breath Tests; Clarithromycin - adverse effects; Clarithromycin - therapeutic use; Drug Therapy, Combination; Esomeprazole - adverse effects; Esomeprazole - therapeutic use; Feeding. Feeding behavior; Female; Fluoroquinolones; Fundamental and applied biological sciences. Psychology; Gastroenterology; Helicobacter Infections - drug therapy; Helicobacter pylori; Hepatology; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Paper; Pharmacology. Drug treatments; Pilot Projects; Prospective Studies; Quinolines - adverse effects; Quinolines - therapeutic use; Ranitidine - adverse effects; Ranitidine - analogs & derivatives; Ranitidine - therapeutic use; Transplant Surgery; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-008-0285-z

Up to 20% of patients, or even more, will fail to obtain eradication after a standard triple therapy. The aim of this study is to evaluate the efficacy of moxifloxacine-containing regimens in the first-line treatment of Helicobacter pylori. One hundred and twenty H. pylori-positive patients were randomized into four groups to receive one of the following 14-day treatments: ranitidine bismuth citrate (RBC) 400 mg b.d. plus amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. (RAC group, n = 30); RBC 400 mg b.d. plus moxifloxacine 400 mg o.d. and amoxicillin 1,000 mg b.d. (RAM group, n = 30); esomeprazole 40 mg b.d. plus amoxicillin 1,000 mg b.d. plus clarithromycin 500 mg b.d. (EAC group, n = 30); and esomeprazole 40 mg b.d. plus amoxicillin 1,000 mg b.d. plus moxifloxacine 400 mg o.d. (EAM group, n = 30). Eradication was assessed by ¹³C urea breath test 8 weeks after therapy. Per-protocol and intention-to-treat eradication was achieved in 23 out of 30 patients (76.7%, 95% confidence interval [CI]: 61-92) in the RAC group, in 20 patients (66.7%, 95% CI: 49-84) in the RAM group, in 16 patients in the EAM group (53.3%, 95% CI: 34-71), and in 19 patients in the EAC group (63.3%, 95% CI: 54-72). Mild or moderate side-effects were significantly more common in the EAM group (70%) compared to the RAC (36.6%), RAM (43.3%), and EAC (56.6%) groups (P = 0.03). From our results, we conclude that moxifloxacine-containing triple therapies have neither eradication nor compliance advantages over standard triple therapies. Further studies with new antibiotic associations are needed for the better eradication of H. pylori in developing regions of the world.