Moxifloxacin-Containing Triple Therapy versus Bismuth- Containing Quadruple Therapy for Second-Line Treatment of Helicobacter pylori Infection: A Meta-Analysis

摘要

Background: Moxifloxacin-containing triple therapy has been suggested as an alternative second-line therapy for Helicobacter pylori infection. Aims: To systematically review the efficacy and tolerance of moxifloxacincontaining triple therapy in second-line H. pylori eradication, and to conduct a meta-analysis of studies comparing this regimen with bismuth-containing quadruple therapy. Materials and Methods: Electronic databases including Medline, Embase, Cochrane controlled trials register, Web of Science, PubMed, Chinese Biomedical Literature Database (updated to December 2010), and manual searches were conducted. A meta-analysis of all randomized controlled trials (RCTs) comparing moxifloxacin-containing triple therapy to bismuthcontaining quadruple therapy in the second-line treatment of H. pylori infection was performed. Results: Seven RCTs including 787 patients were assessed. The metaanalysis showed that the eradication rate in the moxifloxacin group was significantly higher than that in the quadruple therapy group (74.9 vs 61.4%, OR 1.89, 95% CI: 1.38–2.58, p <.0001); besides, the rates of side effects and discontinuing therapy because of side effects in the moxifloxacin group were significantly lower than those in the quadruple therapy group (side effects: 10.1 vs 27.8%, OR 0.27, 95% CI: 0.18–0.41, p <.00001; discontinuing therapy because of side effects: 1.4 vs 8.2%, OR 0.18, 95% CI: 0.08– 0.40, p <.0001). These results were constant in the sensitivity analyses. Conclusion: Moxifloxacin-containing triple regimen is more effective and better tolerated than the bismuth-containing quadruple therapy in the second- line treatment of H. pylori infection.