Related Experiment Video
Updated: Jun 26, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Gatifloxacin-based triple therapy as a third-line regimen for Helicobacter pylori eradication
Toshihiro Nishizawa1, Hidekazu Suzuki, Izumi Nakagawa
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Background And Aim:
This study was designed to investigate the efficacy of gatifloxacin (GAT)-based triple therapy as a third-line treatment for Helicobacter pylori (H. pylori) eradication, according to the assessment of the susceptibility to GAT and gyrA mutation.
Methods:
Fourteen patients who had eradication failure following both clarithromycin-based triple therapy and metronidazole-based triple therapy, or who were infected with H. pylori isolates that were resistant to both clarithromycin and metronidazole after failure of clarithromycin-based triple therapy, were enrolled. These patients were randomly assigned to two groups: (i) rabeprazole and amoxicillin (RA) and (ii) rabeprazole, amoxicillin, and GAT for 7 days (RAG). The minimal inhibitory concentrations were determined by the agar dilution method. The gyrA gene was examined by sequencing.
Results:
The eradication rate was 0% in the RA group and 75% in the RAG group. The eradication rate in the RAG group was 100% in patients infected with GAT-susceptible bacteria and/or bacteria without gyrA mutations, but was only 33.3% in those infected with GAT-resistant bacteria or bacteria with gyrA mutations.
Conclusion:
Although GAT may be a promising candidate for third-line therapy, its selection must be based on the results of drug susceptibility testing or gyrA analyses.
Insights
Gatifloxacin-based triple therapy shows promise for third-line Helicobacter pylori eradication. Success depends on bacterial susceptibility to gatifloxacin and absence of gyrA mutations.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Helicobacter pylori (H. pylori) eradication failure necessitates effective third-line treatments.
- Antibiotic resistance, including to clarithromycin and metronidazole, complicates H. pylori treatment.
- Gatifloxacin (GAT) is explored as a potential agent for refractory H. pylori infections.
Purpose of the Study:
- To evaluate the efficacy of gatifloxacin-based triple therapy as a third-line H. pylori eradication strategy.
- To assess the impact of gatifloxacin susceptibility and gyrA mutations on treatment outcomes.
- To compare gatifloxacin-based therapy with standard treatment in patients with prior eradication failures.
Main Methods:
- A randomized trial involving 14 patients with H. pylori eradication failure after two prior therapies.
- Patients received either rabeprazole and amoxicillin (RA) or rabeprazole, amoxicillin, and gatifloxacin (RAG) for 7 days.
- Gatifloxacin susceptibility was determined using minimal inhibitory concentrations, and gyrA gene mutations were analyzed via sequencing.
Main Results:
- The RAG group achieved a 75% H. pylori eradication rate, compared to 0% in the RA group.
- Eradication was 100% successful in patients with gatifloxacin-susceptible H. pylori and/or no gyrA mutations.
- Eradication rates dropped to 33.3% in patients with gatifloxacin-resistant strains or gyrA mutations.
Conclusions:
- Gatifloxacin-based triple therapy is a viable option for third-line H. pylori eradication.
- Drug susceptibility testing and gyrA mutation analysis are crucial for selecting gatifloxacin for treatment.
- Personalized treatment approaches based on antimicrobial resistance patterns can improve H. pylori eradication success.
More Related Videos
06:40Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
04:56Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:28Inhibitors of Bacterial DNA Synthesis
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...