Efficacy of rifabutin-based triple therapy in Helicobacter pylori infected patients after two standard treatments

• Published in: Journal of gastroenterology and hepatology Vol. 22; no. 1; pp. 60 - 63
• Main Authors: González Carro, Pedro, Pérez Roldán, Francisco, De Pedro Esteban, Aurora, Legaz Huidobro, Maria L., Soto Fernández, Susana, Roncero Garcia Escribano, Oscar, Esteban López-Jamar, Jose M., Pedraza Martin, Carmen, Ruíz Carrillo, Francisco
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-01-2007; Blackwell Science
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Aged; Aged, 80 and over; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Chi-Square Distribution; Drug Therapy, Combination; Female; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - drug effects; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; rescue therapy; rifabutin; Rifabutin - therapeutic use; Statistics, Nonparametric; Treatment Outcome; triple therapy; H; Spirillaceae; Antiulcer agent; K; Proton pump inhibitor; Penicillin derivatives; Helicobacter pylori; triple therapy; Antisecretory agent; Bacteria; Antituberculous agent; Human; Drug combination; Spirillales; Pantoprazole; Enzyme; rescue therapy; β-Lactams; Treatment efficiency; Enzyme inhibitor; Infection; Rifabutin; Antibiotic; Benzimidazole derivatives; Amoxicillin; Bacteriosis; exchanging ATPase; Hydrolases; Salvage treatment; Antibacterial agent
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2006.04375.x

Background and Aim:  Even with the current most effective treatment regimens for Helicobacter pylori infection, a considerable number of patients will be resistant to eradication. The aim of the present study was to evaluate the H. pylori eradication rate in patients resistant to standard therapies when treated with a triple therapy of pantoprazole, rifabutin and amoxicillin.
Methods:  Ninety‐two consecutive patients diagnosed with H. pylori infection resistant to two previous treatment regimens were treated with pantoprazole, rifabutin and amoxicillin for 10 days. The persistence or eradication of H. pylori was determined by a 13C‐urea breath test performed 4 weeks after the treatment.
Results:  Per protocol eradication was achieved in 62.2% of patients and the intention‐to‐treat eradication was 60.8%. Only two patients were excluded for adverse events related to the treatment.
Conclusions:  The eradication rate is acceptable as a third‐line therapy, particularly in centers with high cure rate for first line therapy. Another important value of this study is the good tolerance for the treatment observed in our patients. It is possible that rifabutin‐based triple therapy may be of use in hospital centers that do not have disposable culture and susceptibility methods against H. pylori.