Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments

Gisbert, Javier P.; Romano, Marco; Molina–Infante, Javier; Lucendo, Alfredo J.; Medina, Enrique; Modolell, Inés; Rodríguez-Téllez, Manuel; Gomez, Blas J.; Barrio, Jesús; Perona, Mónica; Ortuño, Juan; Ariño, I.; Domínguez–Muñoz, J. Enrique; Pérez-Aísa, Ángeles; Bermejo, Fernando; Dominguez, J.; Almela, Pedro; Gómez‐Camarero, Judith; Millastre, Judith; Martín-Noguerol, Elisa; Gravina, Antonietta Gerarda; Martorano, Marco; Miranda, Agnese; Federico, Alessandro; Fernandez-Bermejo, Miguel; Angueira, Teresa; Ferrer-Barceló, Luis; Fernández, Nuria; Marín, Alicia C; McNicholl, Adrián G.

doi:10.1016/j.dld.2014.10.009

Cited by 25 publications

(14 citation statements)

References 63 publications

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“…In 2013, LEV was replaced by MOX, the dose of PPI was escalated to high‐dose esomeprazole and the duration was prolonged to 14 days. The second‐line eradication rate of the PPI‐MOX‐AMO triple therapy rose to 86%, figure similar to that in a multicentre study that evaluated this treatment in 250 patients and to that seen in a recent meta‐analysis on the use of fourth generation quinolones in Asia and Europe . However, the current cost of a 14 day‐treatment with esomeprazole 40 mg, MOX and AMO in Spain is € 66.26.…”

Section: Discussionsupporting

confidence: 76%

Empirical Helicobacter pylori rescue therapy: an 18‐year single‐centre study of 1200 patients

2019

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Background: Manychangeshavebeenmadetotheguidelinesonrescuetreatmentsfor Helicobacter pylori infection due to their poor effectiveness in clinical practice.Objective: To evaluate the use and effectiveness of different empirical rescue therapies for H. pylori infection in a specialised consultation unit over 18 years. Methods:Design: analysis of a systematic, prospective, single-centre data record.Patients: consecutive patients in whom at least one H. pylori eradication regimen had failed. Intervention: consecutive rescue therapies were prescribed empirically according to the best scientific evidence. Helicobacter pylori eradication was defined by a negative 13 C-ureabreathtest.Results: A total of 1200 subjects were included. Eleven different therapies were used during the study period, being the seven most common: proton pump inhibitor (PPI)-levofloxacin (LEV)-amoxicillin (AMO); PPI-bismuth(BIS)-LEV-AMO; PPI-moxifloxacin-AMO; ranitidine bismuth citrate-tetracycline-metronidazole; classical BIS (BIS)-containing quadruple therapy; PPI-Pylera ® and PPI-rifabutin (RIF)-AMO. The effectivenessofthesecond-,third-,fourth-andfifth-linerescuetherapieswas77%, 71%,60%and58%,respectively.Thecumulativeeffectivenessafterfiveconsecutive therapieswas99.8%.Thethreemosteffectivesecond-andthird-linetherapieswere: PPI-Pylera ® (96%and82%,respectively),classicalBIS-containingquadrupletherapy (92%and89%)andPPI-BIS-LEV-AMO(88%and84%). Conclusions: Helicobacter pylori eradication can be achieved virtually in all cases by the administration of several consecutive empirical therapies. The most effective second-linestrategyistheadministrationofaBIS-containingquadrupletherapy(either classical, Pylera ® or with LEV-AMO). The most effective third-line strategy is theadministrationofanotpreviouslyusedBIS-containingquadrupletherapy.Agood alternativeasafourth-linetherapyistheadministrationofPPI-RIF-AMO-BIS.

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Section: Discussionsupporting

confidence: 76%

Empirical Helicobacter pylori rescue therapy: an 18‐year single‐centre study of 1200 patients

2019

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“…Some authors have included moxifloxacin instead of levofloxacin in this triple rescue regimen (moxifloxacin-amoxicillin-PPI), achieving an overall eradication rate of 71%249 265 266 after failure of non-BQTs. These results should be interpreted with caution, due the heterogeneity of the data and the differences between study characteristics.…”

Section: Working Group 3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

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“…Moxifloxacin-containing triple therapies have been studied in some parts of the world. [130][131][132][133] Several meta-analyses of RCTs have reported that this regimen is better tolerated than bismuth quadruple therapy and is as effective in the first-line setting 130 and more effective in the second-line setting. 130,131 However, moxifloxacin is affected by the same high prevalence of fluoroquinolone resistance as levofloxacin (see statement 6).…”

Section: Future Directionsmentioning

confidence: 99%

The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults

et al. 2016

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Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments

Cited by 25 publications

References 63 publications

Empirical Helicobacter pylori rescue therapy: an 18‐year single‐centre study of 1200 patients

Empirical Helicobacter pylori rescue therapy: an 18‐year single‐centre study of 1200 patients

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults

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