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High Helicobacter pylori cure rate with sitafloxacin‐based triple therapy
Author(s) -
Sugimoto M.,
Sahara S.,
Ichikawa H.,
Kagami T.,
Uotani T.,
Furuta T.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13280
Subject(s) - medicine , metronidazole , helicobacter pylori , regimen , gastroenterology , rabeprazole , breath test , urea breath test , confidence interval , antibiotics , microbiology and biotechnology , helicobacter pylori infection , biology
Summary Background Bacterial resistance of Helicobacter pylori to antibiotics is increasing and it often leads to failure of antibiotic treatment. A new sitafloxacin‐based triple therapy was developed to counter this situation; the fluoroquinolone sitafloxacin has a low minimum inhibitory concentration for H. pylori . Aim To investigate the efficacy in Japanese patients of sitafloxacin‐based triple therapy and document its efficacy in relation to anti‐microbial susceptibility. Methods We investigated the efficacy of a 1‐week sitafloxicin‐based regimen of rabeprazole 10 mg four times daily (q.d.s.), metronidazole 250 mg twice daily (b.d.) and sitafloxacin 100 mg b.d. in 180 H. pylori ‐positive Japanese patients (first‐line treatment: n = 45, second‐line; n = 41, third‐line: n = 94). At 8 weeks, patients were given the 13 C‐urea breath test to assess eradication status. Results Eradication rate was 92.2% [95% confidence interval ( CI ): 87.3–95.7%, 166/180] in intention‐to‐treat analysis. Although the eradication rate was higher in patients treated with first‐line therapy [45/45 (100%, 95% CI : 83.4–100%)] than in those with second‐ [38/41 (92.7%, 80.1–98.5%)] or third‐line therapy [83/94 (88.3%, 80.0–94.0%)], no significant differences were noted with respect to the number of previous therapy attempts ( P = 0.054). Eradication rates in patients infected with sensitive‐ and resistant strains to metronidazole were 96.6% (28/29) and 96.3% (77/80) ( P = 0.941), respectively, while rates were 98.4% (60/61) in sitafloxacin‐sensitive and 50.0% (1/2) in sitafloxacin resistant strains ( P < 0.001). Conclusion Sitofloxacin‐based triple therapy with metronidazole b.d. and rabeprazole q.d.s. achieved an eradication rate exceeding 88%, irrespective of eradication history, CYP 2C19 genotype, or metronidazole resistance status.