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- Title
Efficacy and safety of rifabutin-containing ‘rescue therapy’ for resistant Helicobacter pylori infection.
- Authors
BORODY, T. J.; PANG, G.; WETTSTEIN, A. R.; CLANCY, R.; HERDMAN, K.; SURACE, R.; LLORENTE, R.; NG, C.
- Abstract
Background Current ‘rescue’ therapies provide inadequate Helicobacter pylori eradication rates because of antibiotic resistance. Aim To test the efficacy of a modified triple regimen combining rifabutin, pantoprazole and amoxicillin as rescue therapy for patients in whom eradication of H. pylori had failed standard clarithromycin-based triple therapy. Methods One hundred and thirty patients (mean age 51.7 ± 14.8 years) who had failed one or more eradication attempts with omeprazole, clarithromycin and amoxicillin were treated for 12 days with rifabutin 150 mg daily, amoxicillin 1 g or 1.5 g t.d.s, and pantoprazole 80 mg t.d.s. Results The intention-to-treat and per-protocol eradication rates were 90.8/90.8%. Metronidazole or/and clarithromycin resistance had no significant impact on H. pylori eradication rates. A higher overall eradication rate of 96.6% (95% CI: 92.1–101%) was obtained in patients treated with a regimen containing 1.5 g amoxicillin t.d.s compared with 90.7% (95% CI: 82–98.6%) using a regimen with 1 g amoxicillin t.d.s but the difference was not significant. Side-effects reported in 40% of patients were mild. Conclusion A 12-day course of low dose of rifabutin with an increased dose of amoxicillin and pantoprazole is well-tolerated and highly effective against dual-resistant H. pylori infection after failure of triple therapy.
- Subjects
HELICOBACTER pylori; HELICOBACTER; ANTIBIOTICS; ANTI-infective agents; MICROBIAL metabolites; AMOXICILLIN; PENICILLIN; OMEPRAZOLE; ANTIULCER drugs; METRONIDAZOLE
- Publication
Alimentary Pharmacology & Therapeutics, 2006, Vol 23, Issue 4, p481
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2006.02793.x