Randomized Trial on 14 versus 7 days of Esomeprazole, Moxifloxacin, and Amoxicillin for Second-line or Rescue Treatment of Helicobacter pylori Infection

Miehlke, Stephan; Krasz, Susanne; Schneider-Brachert, Wulf; Kuhlisch, Eberhard; Berning, Marco; Madisch, Ahmed; Laaß, Martin W.; Neumeyer, Michael; Jebens, Claus; Zekorn, C; Knoth, Holger; Vieth, Michael; Stolte, Manfred; Lehn, Norbert; Morgner, Andrea

doi:10.1111/j.1523-5378.2011.00867.x

Cited by 47 publications

(10 citation statements)

References 30 publications

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“…As in other publications, antibiotic-based therapies were shown to have similar efficacy in our study [20,21,22,23,24,25,26]. We believe that using quinolon-based therapies in first-line treatment in areas where clarithromycin resistance is higher than 20% is an appropriate approach, since treatment options are limited and quinolon resistance is not a big problem yet.…”

Section: Discussionsupporting

confidence: 53%

Comparison of Levofloxacin- and Moxifloxacin-Based Triple Therapies with Standard Treatment in Eradication of Helicobacter Pylori as First-Line Therapy

Rakici

Ayaz²,

Akdoğan³

et al. 2014

Digestion

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Aim: It is recommended that treatments that include clarithromycin should be avoided in eradication of Helicobacter pylori (HP) in cases where clarithromycin resistance is higher than 20%. We aimed to compare levofloxacin- and moxifloxacin-based triple therapies with standard treatment and with each other in eradication of helicobacter pylori as first-line therapy. Materials and Methods: Patients were randomized prospectively as three groups. There were 102 patients in the levofloxacin group, 101 patients in the moxifloxacin group, and 103 patients in the standard treatment group. The patients received levofloxacin 500 mg daily, amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. for ten days (LAL) in the levofloxacin group; moxifloxacin 400 mg daily, amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. (MAL) in the moxifloxacin group; and clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. (CAL) in the standard treatment group. At post-treatment week 6, HP was checked by using stool antigen test. Results: In the eradication of Helicobacter pylori, the success rate as determined by per protocol (PP) analysis was 92% in the LAL group, 91.8% in the MAL group, and 82.4% in the CAL group. A statistically significant difference was found in the LAL and MAL groups compared to the CAL group (p < 0.05). There was no difference between the LAL and MAL groups. Conclusions: It was determined that levofloxacin- and moxifloxacin-based triple therapies were more effective than the standard treatment in first-line setting in the eradication of Helicobacter pylori. In addition, no difference was found between levofloxacin- and moxifloxacin-based triple therapies. Currently observed high efficacy may be evaluated in treatment. Although quinolon resistance is not considered a major problem, it appears to be a factor that may reduce treatment success over a period of time.

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Section: Discussionsupporting

confidence: 53%

Comparison of Levofloxacin- and Moxifloxacin-Based Triple Therapies with Standard Treatment in Eradication of Helicobacter Pylori as First-Line Therapy

Rakici

Ayaz²,

Akdoğan³

et al. 2014

Digestion

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“…None of these studies with 7–10 days of levofloxacin-containing triple therapies attained 90% or better treatment success. Two recently published studies reported that extending the length of quinolone-containing triple therapies to 14 days could achieve eradication success up to 95% (moxifloxacin) and 93.6% (levofloxacin) [35, 36]. Consequently, the current study achieved an eradication rate of 92.5% in the EAL-14 group in PP analysis but only 75.6% in the EAL-10 group.…”

Section: Discussionmentioning

confidence: 52%

Ten-Day versus 14-Day Levofloxacin-Containing Triple Therapy for Second-Line Anti-Helicobacter pyloriEradication in Taiwan

Tai

Chiu

Liang

et al. 2013

Gastroenterology Research and Practice

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Second-line Helicobacter pylori (H. pylori) eradication with fluoroquinolone-containing triple therapy is one of the recommended treatment options, but neither 7-day nor 10-day regimens provide >90% success rates. The current retrospective study aimed to clarify the effects of 10-day and 14-day levofloxacin-containing triple therapies for second-line H. pylori eradication in a Taiwanese cohort and to evaluate the potential clinical factors influencing eradication. A total of 200 patients who failed H. pylori eradication using the standard triple therapy were prescribed with either a 10-day (EAL-10) or a 14-day (EAL-14) levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily). Follow-up studies to assess treatment response were carried out 8 weeks later. Eradication rates attained by EAL-10 and EAL-14 were 75.6%; 95% CI = 63.9–85.3% and 92.5%; 95% CI = 84.5–98.1%, P = 0.002 in the per protocol analysis and 68%; 95% CI = 56.6–78.5% and 86%; 95% CI = 76.8–93.4%, P = 0.002 in the intention-to-treat analysis. The duration of H. pylori therapy is the independent risk factor of H. pylori eradication (P = 0.003). In conclusion, 14-day levofloxacin-containing triple therapy can provide a >90% H. pylori eradication rate, but 10-day treatment duration may be suboptimal. The longer duration of H. pylori therapy (14 days) is the independent risk factor.

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“…Currently, ophthalmic release of the antibiotics between 7 and 14 days is suggested to increase bacterial eradication and to avoid possible adverse events [23]. The controlled release of moxifloxacin for 10 days, as achieved in this study, may lead to development of a moxifloxacin in situ gelling microparticles–bioadhesive delivery system that may be applied in one dose and will have a much higher efficacy than conventional eyedrop formulations have.…”

Section: Resultsmentioning

confidence: 92%

Moxifloxacin in situ gelling microparticles–bioadhesive delivery system

Guo

Aly

Schein

et al. 2012

Results in Pharma Sciences

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Antibiotic use for ocular treatments has been largely limited by poor local bioavailability with conventional eyedrops formulations. Here, we developed a controlled delivery system composed of moxifloxacin-loaded poly(lactic-co-glycolic acid) (PLGA) microparticles encapsulated in a chondroitin sulfate-based, two-component bioadhesive hydrogel. Using a simple and fast electrohydrodynamic spray drying (electrospraying) technique, surfactant-free moxifloxacin-loaded microparticles were fabricated with diameters on the order of 1 μm. A mixed solvent system of methanol/dichloromethane (MeOH/DCM) was employed to prepare the microparticles for the electrospraying processing. Extended release of moxifloxacin using a series of MeOH/DCM mixed solvents was accomplished over 10 days with release concentrations higher than the minimum inhibitory concentration (MIC). In contrast, moxifloxacin loaded directly in hydrogels was released rapidly within 24 h. We observed a decrease of the drug release rate from the microparticles when using an increased percentage of methanol in the mixed solvent from 10% to 30% (v/v), which can be explained by the mixed solvent system providing a driving force to form a gradient of the drug concentrations inside the microparticles. In addition, the delivery system developed in this study, which incorporates a bioadhesive to localize drug release by in situ gelling, may potentially integrate antibiotic prophylaxis and wound healing in the eye.

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Randomized Trial on 14 versus 7 days of Esomeprazole, Moxifloxacin, and Amoxicillin for Second-line or Rescue Treatment of Helicobacter pylori Infection

Abstract: Second-line/rescue H. pylori eradication therapy with esomeprazole, moxifloxacin, and amoxicillin is very effective and well tolerated. Fourteen days of treatment significantly increase the eradication rate but also the rate of adverse events.

Cited by 47 publications

References 30 publications

Comparison of Levofloxacin- and Moxifloxacin-Based Triple Therapies with Standard Treatment in Eradication of Helicobacter Pylori as First-Line Therapy

Comparison of Levofloxacin- and Moxifloxacin-Based Triple Therapies with Standard Treatment in Eradication of Helicobacter Pylori as First-Line Therapy

Ten-Day versus 14-Day Levofloxacin-Containing Triple Therapy for Second-Line Anti-Helicobacter pyloriEradication in Taiwan

Moxifloxacin in situ gelling microparticles–bioadhesive delivery system

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