헬리코박터 파일로리의 3차 구제요법에서 리파부틴과 레보플록사신의 비교

Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures....

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Published in:The Korean journal of gastroenterology Vol. 59; no. 6; pp. 401 - 406
Main Authors: 정명호, Myung Ho Jeong, 정준원, Jun Won Chung, 이상진, Sang Jin Lee, 하민수, Minsu Ha, 정석후, Seok Hoo Jeong, 나선영, Sunyoung Na, 나병수, Byung Soo Na, 박성근, Sung Keun Park, 김윤재, Yoon Jae Kim, 권광안, Kwang An Kwon, 고광일, Kwang Il Ko
Format: Journal Article
Language:Korean
Published: 대한소화기학회 30-06-2012
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Abstract Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures. Methods: Patients, in whom a first treatment with proton pump inhibitor-clarithromycin-amoxicillin and a second trial with proton pump inhibitor-bismuth-tetracycline-metronidazole had failed, received treatment with either rifabutin or levofloxacin, plus amoxicillin (1 g twice daily) and standard dose proton pump inhibitor. Eradication rates were confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy. Results: Eradication rates were 71.4% in the rifabutin group, and 57.1% in the levofloxacin group, respectively. Although there was no significant difference in Helicobacter pylori eradication rates between two groups (p=0.656), rifabutin based regimen showed relatively higher eradication rate. Conclusions: Helicobacter pylori eradication rates of rifabutin- or levofloxacin-based triple therapy could not achieve enough eradication rate. Further studies would be needed on combination of levofloxacin and rifabutin-based regimen or culture based treatment. (Korean J Gastroenterol 2012;59:401-406)
AbstractList Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures. Methods: Patients, in whom a first treatment with proton pump inhibitor-clarithromycin-amoxicillin and a second trial with proton pump inhibitor-bismuth-tetracycline-metronidazole had failed, received treatment with either rifabutin or levofloxacin, plus amoxicillin (1 g twice daily) and standard dose proton pump inhibitor. Eradication rates were confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy. Results: Eradication rates were 71.4% in the rifabutin group, and 57.1% in the levofloxacin group, respectively. Although there was no significant difference in Helicobacter pylori eradication rates between two groups (p=0.656), rifabutin based regimen showed relatively higher eradication rate. Conclusions: Helicobacter pylori eradication rates of rifabutin- or levofloxacin-based triple therapy could not achieve enough eradication rate. Further studies would be needed on combination of levofloxacin and rifabutin-based regimen or culture based treatment. (Korean J Gastroenterol 2012;59:401-406)
목적: 항균제 내성의 증가로 H. pylori 3차 구제요법의 필요성이 증가하고 있다. 이번 연구는 3차 구제요법들 중 levofloxacin요법과rifabutin요법의 제균율을 비교하고자 하였다. 대상 및 방법: 1차 표준치료와 bismuth 기반 2차 사제요법에실패한 환자들에게 levofloxacin을 포함한 삼제요법과 rifabutin을포함한 삼제요법을 투여하였다. 제균율은 치료중지4주 후 요소호기검사와 신속 요소분해검사를 통하여 비교하였다. 결과: Levofloxacin 투여군 총 14명 중 8명(57.1%), rifabutin 투여군 총 7명 중 5명(71.4%)이 박멸되어 양 군 간의 제균율은 통계학적으로 유의한 차이를 보이지 않았으나(p=0.656),상대적으로 rifabutin 투여군의 제균율이 더 높게 나왔다. 결론: H. pylori 3차 제균요법으로 levofloxacin 혹은 rifabutin 기반 삼제요법 두 군 모두 충분한 제균율을 보이지 못하였다. 향후 levofloxacin과 rifabutin 병합요법이나 배양검사에기초한 제균치료가 필요하겠다. Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures. Methods: Patients, in whom a first treatment with proton pump inhibitor-clarithromycin-amoxicillin and a second trial with proton pump inhibitor-bismuth-tetracycline-metronidazole had failed, received treatment with either rifabutin or levofloxacin,plus amoxicillin (1 g twice daily) and standard dose proton pump inhibitor. Eradication rates were confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy. Results: Eradication rates were 71.4% in the rifabutin group, and 57.1% in the levofloxacin group, respectively. Although there was no significant difference in Helicobacter pylori eradication rates between two groups (p=0.656), rifabutin based regimen showed relatively higher eradication rate. Conclusions: Helicobacter pylori eradication rates of rifabutin- or levofloxacin-based triple therapy could not achieve enough eradication rate. Further studies would be needed on combination of levofloxacin and rifabutin-based regimen or culture based treatment. KCI Citation Count: 11
Author Kwang An Kwon
권광안
Sunyoung Na
Byung Soo Na
Kwang Il Ko
Myung Ho Jeong
하민수
정준원
Minsu Ha
정명호
김윤재
나병수
Yoon Jae Kim
Jun Won Chung
이상진
고광일
나선영
Sang Jin Lee
Sung Keun Park
박성근
정석후
Seok Hoo Jeong
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Comparison of Rifabutin- and Levofloxacin-based Third-line Rescue Therapies for Helicobacter pylori
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Snippet Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this...
목적: 항균제 내성의 증가로 H. pylori 3차 구제요법의 필요성이 증가하고 있다. 이번 연구는 3차 구제요법들 중 levofloxacin요법과rifabutin요법의 제균율을 비교하고자 하였다. 대상 및 방법: 1차 표준치료와 bismuth 기반 2차 사제요법에실패한 환자들에게...
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SubjectTerms Helicobacter pylori
Levofloxacin
Rifabutin
Salvage therapy
Third Line
내과학
Title 헬리코박터 파일로리의 3차 구제요법에서 리파부틴과 레보플록사신의 비교
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