Comparison of rifabutin- and levofloxacin-based third-line rescue therapies for Helicobacter pylori

• Published in: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Vol. 59; no. 6; p. 401
• Main Authors: Jeong, Myung Ho, Chung, Jun-Won, Lee, Sang Jin, Ha, Minsu, Jeong, Seok Hoo, Na, Sunyoung, Na, Byung Soo, Park, Sung Keun, Kim, Yoon Jae, Kwon, Kwang An, Ko, Kwang Il, Jo, Yunjeong, Hahm, Ki Baik, Jung, Hwoon-Yong
• Format: Journal Article
• Language: Korean
• Published: Korea (South) 25-06-2012
• Subjects: Adult; Aged; Aged, 80 and over; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Breath Tests; Drug Resistance, Bacterial - drug effects; Drug Therapy, Combination; Female; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin - therapeutic use; Proton Pump Inhibitors - therapeutic use; Rifabutin - therapeutic use; Salvage Therapy
• ISSN: 2233-6869

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.
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.
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.
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.