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Rifabutin‐based ‘rescue therapy’ for Helicobacter pylori infected patients after failure of standard regimens
Author(s) -
Francesco Perri,
V. Festa,
R. Clemente,
Michele Quitadamo,
Angelo Andriulli
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.00719.x
Subject(s) - rifabutin , medicine , regimen , tolerability , gastroenterology , pantoprazole , helicobacter pylori , proton pump inhibitor , clarithromycin , breath test , amoxicillin , surgery , adverse effect , antibiotics , omeprazole , microbiology and biotechnology , biology
Background: The ideal treatment for patients who have failed eradication of Helicobacter pylori infection after standard proton pump inhibitor‐based triple therapies has still to be determined. Although either a second course of triple therapy or a quadruple therapy (proton pump inhibitor plus bismuth‐based triple therapy) has been proposed, the efficacy of these second‐line therapies is relatively unknown. Therefore, alternative strategies are needed. Aim: To assess the efficacy and tolerability of rifabutin, a derivative of rifamycin‐S, in patients who were still H. pylori infected after two or more courses of 1‐week triple therapies. Methods: Patients were given a 1‐week regimen of pantoprazole 40 mg b.d. + amoxycillin 1 g b.d. + rifabutin 300 mg daily. Side‐effects and compliance were determined at the end of therapy. Eradication rate was assessed with a 13 C‐urea breath test performed at 4 and 12 weeks after treatment. Results: Forty‐one patients (mean age 47 ± 15 years) were studied. All patients took medications according to the proposed schedule. Side‐effects were infrequent and mild. The eradication rates were 71% (95% CI: 57–85%) on intention‐to‐treat analysis and 74% (95% CI: 61–88%) on per protocol analysis. Conclusions: Rifabutin, in combination with pantoprazole and amoxycillin, is an effective and well tolerated regimen in patients who failed standard eradication treatments.