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Gatifloxacin‐based triple therapy as a third‐line regimen for Helicobacter pylori eradication
Author(s) -
Nishizawa Toshihiro,
Suzuki Hidekazu,
Nakagawa Izumi,
Iwasaki Eisuke,
Masaoka Tatsuhiro,
Hibi Toshifumi
Publication year - 2008
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2008.05407.x
Subject(s) - clarithromycin , amoxicillin , gatifloxacin , helicobacter pylori , medicine , metronidazole , regimen , agar dilution , rabeprazole , microbiology and biotechnology , antibiotics , gastroenterology , minimum inhibitory concentration , levofloxacin , biology
Background and Aim: This study was designed to investigate the efficacy of gatifloxacin (GAT)–based triple therapy as a third‐line treatment for Helicobacter pylori ( H. pylori ) eradication, according to the assessment of the susceptibility to GAT and gyrA mutation. Methods: Fourteen patients who had eradication failure following both clarithromycin‐based triple therapy and metronidazole‐based triple therapy, or who were infected with H. pylori isolates that were resistant to both clarithromycin and metronidazole after failure of clarithromycin‐based triple therapy, were enrolled. These patients were randomly assigned to two groups: (i) rabeprazole and amoxicillin (RA) and (ii) rabeprazole, amoxicillin, and GAT for 7 days (RAG). The minimal inhibitory concentrations were determined by the agar dilution method. The gyrA gene was examined by sequencing. Results: The eradication rate was 0% in the RA group and 75% in the RAG group. The eradication rate in the RAG group was 100% in patients infected with GAT‐susceptible bacteria and/or bacteria without gyrA mutations, but was only 33.3% in those infected with GAT‐resistant bacteria or bacteria with gyrA mutations. Conclusion: Although GAT may be a promising candidate for third‐line therapy, its selection must be based on the results of drug susceptibility testing or gyrA analyses.