Efficacy of triple therapy with esomeprazole, amoxicillin, and sitafloxacin as a third-line Helicobacter pylori eradication regimen

Objective: To examine the efficacy of third-line Helicobacter pylori eradication therapy with esomeprazole, amoxicillin, and sitafloxacin for patients with clarithromycin-and metronidazole-based first-and second-line therapy failure. Methods: Thirty patients with first-and second-line H. pylori eradication failure were treated prospectively with esomeprazole 20 mg twice daily, amoxicillin 750 mg twice daily, and sitafloxacin 100 mg twice daily for 7 days. After 8-12 weeks, the outcome of eradication therapy was assessed by C-13-urea breath test or stool antigen test. Results: All 30 patients completed the study. Eradication was successful in 25 patients and the eradication rate was 83% in the intention-to-treat and per-protocol analyses. No specific or significant adverse events were recorded in the 30 patients. Patient characteristics such as sex, body mass index, and pepsinogen I/II ratio did not differ between patients who were treated successfully and those who were not treated successfully. Conclusions: Third-line H. pylori eradication therapy with esomeprazole, amoxicillin, and sitafloxacin is as safe and effective as previously reported sitafloxacin-based triple therapy. (C) 2016 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.