Efficacy of Moxifloxacin Plus Nitazoxanide Based Sequential Triple Therapy for Eradication of Helicobacter Pylori Infection

Abstract

Background: Helicobacter pylori eradication rates has been suboptimal despite multiple-drug regimens owing to increasing drug resistance. Purpose: To assess the efficacy of a novel sequential therapy based on moxifloxacin and nitazoxanide for eradication of Helicobacter pylori infection and ulcer healing. Material and Methods: From January 2018 to December 2019, 160 patients of duodenal ulcer related to H. pylori infection received this novel sequential therapy for 14 days. H. pylori infection was diagnosed on histologic evidence of H. pylori by modified Giemsa staining or a positive rapid urease test by gastric mucosal biopsy. Upper gastrointestinal endoscopy was repeated to assess for healing of ulcers. Successful eradication of H. pylori infection was defined as a negative 13C-urea breath test four weeks after the completion of treatment. H. pylori eradication rates, ulcer healing, treatment compliance and adverse events were end-points of the study. Results: The H. pylori eradication rate was 91.5%. The duodenal ulcer healing was complete in 96% and partial in 4% patients. The adverse events reported in 42 (27.2%) patients were mostly mild-to-moderate in severity. Conclusion: This novel sequential therapy based on moxifloxacin and nitazoxanide of Helicobacter pylori infection eradication was found to be highly effective. The duodenal ulcer healing rate was also very high. Moreover, it showed very good tolerability and safety profile.