Changes in the Eradication Efficacy of Fluoroquinolone-containing Triple Therapy for Helicobacter pylori Infection in Korea

Abstract

Background/Aims: Fluoroquinolone-containing triple eradication therapy could be considered an alternative regimen for the second- line treatment of <i>Helicobacter pylori</i> infection. This study aimed to investigate the changes in the eradication efficacy of fluoroquinolone- containing triple therapy from 2003 to 2018 in Korea.Materials and Methods: Patients with a history of first-line eradication therapy failure were consecutively enrolled at Seoul National University Bundang Hospital from 2003 to 2018. All patients took moxifloxacin-containing triple therapy as the second-line eradication therapy. The treatment regimen comprised a three-drug combination comprising a proton pump inhibitor, amoxicillin, and moxifloxacin. Data on age, sex, endoscopic diagnosis, eradication results, compliance, and adverse outcomes were acquired and analyzed.Results: In total, 824 participants were enrolled during the study period, of whom, 46 were lost to follow-up. Finally, 778 participants were included in the per-protocol (PP) analysis, of whom, 72.1% received moxifloxacin-containing triple therapy for 14 days. The eradication rate of moxifloxacin-containing triple therapy was 72.1% (594/824) in the intention-to-treat analysis and 76.3% (594/778) in the PP analysis. A decline in eradication efficacy was observed, especially in the PP analysis (<i>P</i>=0.046). Diarrhea was the most commonly observed adverse event, accounting for 19.6% (41/209) of recorded adverse events.Conclusions: Moxifloxacin-containing triple therapy has shown suboptimal eradication efficacy as the second-line eradication therapy. In addition, there is a concern that eradication rate will decrease due to increase in antimicrobial resistance.