ArticleBMC gastroenterology2025
Efficacy of a 7-day vonoprazan, sitafloxacin, and amoxicillin triple therapy as a fourth-line salvage regimen for refractory Helicobacter pylori infection.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of antibiotic regimens forFrontiers in medicine · 2026Pooled it
- Some Newer Antibiotics Active AgainstAntibiotics (Basel, Switzerland) · 2026Review
- Third-Line and Later Susceptibility-GuidedJournal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment failure of three standard regimens for Helicobacter pylori infections has increased and represents a significant challenge. The VAS regimen, consisting of vonoprazan, amoxicillin, and sitafloxacin, represents a promising treatment option, supported by its strong acid suppression and broad-spectrum antimicrobial activity.
objectivesTo evaluate the efficacy and safety of the VAS regimen as the fourth-line regimen for refractory H. pylori infection.
methodsThis prospective single-arm study involved patients with H. pylori infection who had failed three standard regimens. Participants received VAS regimen; comprising vonoprazan 20 mg twice daily, amoxicillin 1000 mg twice daily, and sitafloxacin 100 mg twice daily for 7 days. Genotypic resistance was identified and CYP2C19 and CYP3A5 were studied. Eradication success was assessed using the 13C-urea breath test at 4-8 weeks post-therapy.
resultsTwenty patients (mean age 64.4 ± 8.6 years) were enrolled. The eradication rate was 70.0% (95% confidence interval (CI): 45.7–88.1) in the intention-to-treat analysis and 68.42% (95% CI: 43.5–87.4) in the per-protocol analysis. Notably, genotypic resistance demonstrated 93.9% and 85.7% of levofloxacin and clarithromycin resistance respectively. Mild adverse events were reported by three patients (15%), including loose stools, nausea, and bloating. Neither antibiotic resistance nor CYP2C19 and CYP3A5 rapid metabolizer status was associated with eradication failure.
conclusionThe seven-day VAS regimen was well tolerated and demonstrated acceptably good efficacy as the fourth-line treatment for refractory H. pylori infection. The regimen offers a reasonably viable empirical rescue when lack of antibiotic susceptibility testing.
trial registrationThai Clinical Trials Registry (Identifier: TCTR20211203002, December 3, 2021).
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