Comparison of standard triple therapy, sequential therapy and moxifloxacin-based triple therapy for Helicobacter pylori infection: Patients' compliance and bacterial eradication rates

Abstract

Objective: To compare the patients' compliance with and the efficacy of existing treatments for Helicobacter pylori eradication, including moxifloxacin-based triple therapy, sequential treatment and the standard treatment.

Methods: Patients with H. pylori infection were randomly assigned to three therapy groups. The triple therapy (MML) group was given moxifloxacin 400 mg/day, metronidazole 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for 10 days. The sequential treatment (AL-CML) group was administrated amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. for the first 5 days, followed by clarithromycin 500 mg b.i.d., metronidazole 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for the second 5 days. The standard treatment (CAL) group received amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days. The eradication rates were evaluated by per-protocol (PP) analysis and intention-to-treat (ITT) analysis.

Results: The eradication rates were 87.1, 85.9 and 85.2% by PP analysis and 87.1, 84.9 and 84.2% by ITT analysis in the MML, AL-CML and CAL group, respectively, and patients' compliance rates were 98.2, 96.5 and 97.1%, respectively. There were no significant differences in treatment efficacy and compliance rates in the MML, AL-CML and CAL groups (P > 0.05).

Conclusions: The present study revealed that standard triple therapy, sequential therapy and moxifloxacin-based triple therapy are all effective treatment regimens in terms of H. pylori eradication rates and compliance with therapy in Turkey.

Keywords: Helicobacter pylori; eradication rate; moxifloxacin; patients' compliance; resistance.