Introduction:
Helicobacter pylori antibiotic resistance continues to be an important issue for decisions regarding eradication treatment. The aim of our study was to compare the efficacy of two bismuth-containing quadruple regimens: one including moxifloxacin, and the other including metronidazole, tetracycline and triple therapy with moxifloxacin as a first-line regimen.

Material and methods:
A total of 332 patients received three different regimens: (a) moxifloxacin-containing bismuth quadruple therapy, BMAR (bismuth subsalicylate 562 mg, BID, moxifloxacin 500 mg QD, amoxicillin 1 g, BID, rabeprazole 20 mg, BID); (b) standard bismuth quadruple therapy, BTMR (bismuth subsalicylate 562 mg, BID, tetracycline 500 mg, QID, metronidazole 500 mg, TID, rabeprazole 20 mg, BID, for 2 weeks); or (c) moxifloxacin-containing triple therapy, MAR (moxifloxacin 500 mg, QD, amoxicillin 1 g, BID and rabeprazole 20 mg, BID).

Results:
The eradication rates of the three groups using ITT analysis were BMAR 93.6%, BTMR 78.4% and MAR 90.8%. Rates were 98.9%, 87% and 99.1%, respectively, using PP analysis. The eradication rate was significantly higher in the BMAR group than in the other groups based on ITT analysis (p < 0.001). There was no significant difference between the BMAR and MAR groups based on PP analysis (p > 0.05); however, the eradication rate was significantly higher in both of the groups than in the BTMR group (p < 0.001).

Conclusions:
Moxifloxacin-containing regimens are efficacious choices for first-line therapy of H. pylori eradication. Adding bismuth therapy to moxifloxacin-based therapies only increases adverse events without increasing the eradication rate.