Efficacy of 14-d vs 7-d moxifloxacin-based triple regimens for second-line Helicobacter pylori eradi

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:KEN_LONG
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AIM: To evaluate the efficacy of the 14-d moxifloxacinbased triple therapy for the second-line eradication of Helicobacter pylori(H. pylori) infection.METHODS: Between 2011 and 2013, we conducted a retrospective review of the medical records of 160 patients who had experienced failure of their first-line proton pump inhibitor-based eradication therapy and subsequently received the moxifloxacin-based triple therapy as a second-line eradication treatment regimen. The patients who were treated with the moxifloxacinbased triple therapy(oral 20 mg rabeprazole b.i.d., 1000 mg amoxicillin b.i.d., and 400 mg moxifloxacin q.d.) for 7 d were assigned to the RAM-7 group(n = 79) while those who took them for 14 days were assigned to RAM-14 group(n = 81). The eradication rates for both groups were determined by intentionto-treat(ITT) and per-protocol(PP) analyses. ITT analysis compared the treatment groups as originally allocated while the PP analysis including only those patients who had completed the treatment as originally allocated. Successful eradication therapy for H. pylori infection was defined as the documentation of a negative 13C-urea breath test 4 wk after the end of the eradication treatment.RESULTS: The overall ITT eradication rate was 76.2%(122/160). The final ITT eradication rates were 70.8%(56/79; 95%CI: 63.3%-77.1%) in the RAM-7 group and 81.4%(66/81; 95%CI: 74.6%-88.3%) in the RAM-14 group(P = 0.034). The overall PP eradication rate was 84.1%(122/145), and the final PP eradication rates were 77.7%(56/72; 95%CI: 70.2%-85.3%) in the RAM-7 group and 90.4%(66/73; 95%CI: 82.8%-98.1%) in the RAM-14 group(P = 0.017). The H. pylori-eradication rates in the RAM-14 group were significantly higher compared with that of the RAM-7 group according to both the ITT(P = 0.034) and the PP analyses(P = 0.017). Both groups exhibited good treatment compliance(RAM-7/RAM-14 group: 100%/100%). The adverse event rates were19.4%(14/72)and 20.5%(15/73)in the RAM-7 and RAM-14 groups,respectively(P=0.441).Adverse events occurred in 14 of the 72 patients(19.4)in the RAM-7 group and in 15 of the 73 patients(20.5)in the RAM-14 group.No statistically significant differences(P=0.441)were observed.CONCLUSION:The 14-d moxifloxacin-based triple therapy is a significantly more effective secondline eradication treatment as compared to the 7-d alternative for H.pylori infection in South Korea. AIM: To evaluate the efficacy of the 14-d moxifloxacinbased triple therapy for the second-line eradication of Helicobacter pylori (H. pylori) infection. METHODS: Between 2011 and 2013, we conducted a retrospective review of the medical records of 160 patients who had experienced failure of their first-line proton pump inhibitor-based eradication therapy and received the moxifloxacin-based triple therapy as a second-line eradication treatment regimen. The patients who were treated with the moxifloxacinbased triple therapy (oral 20 mg rabeprazole bid, 1000 mg amoxicillin bid, and 400 mg moxifloxacin qd) for 7 d were assigned to the RAM-7 group (n = 79) while those who for 14 days were assigned to RAM-14 group (n = 81) rates for both groups were determined by intention to treat (ITT) and per-protocol (PP) analyzes. ITT analysis in the treatment groups as originally allocated while the PP analysis includes only those patients who had completed the treatment as originally allocated. Successful eradication therapy for H. pylori infection was defined as the documentation of a negative 13C-urea breath test 4 wk after the end of the eradication treatment .RESULTS: The overall ITT eradication rate was 76.2% (122 / 160). The final ITT rates were 70.8% (56/79; 95% CI: 63.3% -77.1%) in the RAM-7 group and 81.4% (66/81; 95% CI: 74.6% -88.3% The overall PP eradication rate was 84.1% (122/145), and the final PP eradication rates were 77.7% (56/72; 95% CI: 70.2% -85.3%) in the RAM-14 group The H. pylori-eradication rates in the RAM-14 group were 90.4% (66/73; 95% CI: 82.8% -98.1%) in the RAM-14 group Both groups exhibited good treatment compliance (RAM-7 / RAM-14 group: 100% / 100%). The adverse event rates were 19.4% (14/72) and 20.5% (15/73) in the RAM-7 and RAM-14 groups, respAdam’s significant differences (P = 0.441) .Adverse events occurred in 14 of the 72 patients (19.4) in the RAM-7 group and in 15 of the 73 patients ) were observed. CONCLUSION: The 14-d moxifloxacin-based triple therapy is significantly more effective second line eradication treatment as compared to the 7-d alternative for H. pylori infection in South Korea.
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