The efficacy of moxifloxacin-based triple-therapy in first-line treatment of Helicobacter pylori infection in Pakistan: randomized controlled trials

Introduction The challenge of eradicating Helicobacter pylori through antibiotic treatment is still a significant concern due to the existence of antibiotic resistance. This study aimed to evaluate and compare the efficacy of sequential therapy based on levofloxacin versus triple therapy based on moxifloxacin in treating H. pylori infection in patients receiving first-line treatment. Material and methods A total of 162 patients who were examined positive for H. pylori were randomly assigned to either of 2 groups to receive the following: (a) levofloxacin 500mg BID, amoxicillin 1 g BID, and omeprazole 20 mg BID for the first 5 days, followed by levofloxacin 500 mg BID, tinidazole 500 mg BID, and omeprazole 20 mg BID (LAO-LTO group); or (b) moxifloxacin 400 mg OD, amoxicillin 1 g BID, and omeprazole 20 mg BID (MAO group) for 10 days. Results The eradication rate of H. pylori in the LAO-LTO group was 58.4% (45/77) and 76.3% (45/59), and in the MAO group it was 81.2% (69/85) and 92% (69/75), respectively, in ITT and PP analyses. Eradication rates of moxifloxacin-based triple therapies were significantly higher than those of levofloxacin-based regimens (p < 0.001). The overall incidence of side effects and patient compliance was significantly lower in the moxifloxacin group (p < 0.005) than in the levofloxacin group. Conclusions Moxifloxacin-based triple therapy could be a significantly more effective first-line eradication treatment as compared to levofloxacin-based sequential therapy for H. pylori infection in Pakistan.