Randomized trial on 14 versus 7 days of esomeprazole, moxifloxacin, and amoxicillin for second-line or rescue treatment of Helicobacter pylori infection

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Stephan Miehlke - , Center for Digestive Diseases (Autor:in)
  • Susanne Krasz - , Medizinische Klinik und Poliklinik I (Autor:in)
  • Wulf Schneider-Brachert - , Universität Regensburg (Autor:in)
  • Eberhard Kuhlisch - , Institut für Medizinische Informatik und Biometrie (Autor:in)
  • Marco Berning - , Medizinische Klinik und Poliklinik I (Autor:in)
  • Ahmed Madisch - , Siloah Hospital (Autor:in)
  • Martin W. Laass - , Klinik und Poliklinik für Kinder- und Jugendmedizin (Autor:in)
  • Michael Neumeyer - (Autor:in)
  • Claus Jebens - (Autor:in)
  • Christian Zekorn - (Autor:in)
  • Holger Knoth - , Apotheke (Autor:in)
  • Michael Vieth - , Klinikum Bayreuth GmbH (Autor:in)
  • Manfred Stolte - , Klinikum Kulmbach (Autor:in)
  • Norbert Lehn - , Universität Regensburg (Autor:in)
  • Andrea Morgner - , Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)

Abstract

Background: Triple therapy with a proton pump inhibitor, moxifloxacin, and amoxicillin has been proven effective in first-line treatment of Helicobacter pylori infection. Aim: To explore 1, the value of triple therapy with esomeprazole, moxifloxacin, and amoxicillin in second-line or rescue treatment of Caucasian patients and 2, the impact of treatment duration on eradication success. Methods: H. pylori-infected patients with at least one previous treatment failure were randomized to oral esomeprazole 20mg b.i.d., moxifloxacin 400mg o.d., and amoxicillin 1000mg b.i.d. for either 7 (EMA-7) or 14days (EMA-14). Eradication was confirmed by 13C urea breath test. Antimicrobial susceptibility testing was performed in all patients at baseline and in patients who failed treatment. Results: Eighty patients were randomized, and 60% had ≥2 previous treatment failures. Pretreatment resistance against clarithromycin and metronidazole was found in 70.5 and 61.5% of cases, respectively. The intention-to-treat eradication rate was significantly higher after EMA-14 compared with EMA-7 (95.0 vs 78.9%, p = .036). No independent risk factor for treatment failure could be identified. There were no serious adverse events. Five of the EMA-14 patients (12.5%) compared with none of the EMA-7 patients discontinued prematurely because of adverse events (p = .031). Post-treatment resistance against moxifloxacin was found in one of seven patients with isolated organisms (14.3%). Conclusion: 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.

Details

OriginalspracheEnglisch
Seiten (von - bis)420-426
Seitenumfang7
FachzeitschriftHelicobacter
Jahrgang16
Ausgabenummer6
PublikationsstatusVeröffentlicht - Dez. 2011
Peer-Review-StatusJa

Externe IDs

PubMed 22059392

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Fluoroquinolone, Helicobacter pylori, Levofloxacin, Moxifloxacin