Efficacy of rifabutin‐based triple therapy in <i>Helicobacter pylori</i> infected patients after two standard treatments

Carro, Pedro González; Roldán, Francisco Pérez; Esteban, Aurora de Pedro; Huidobro, María Luisa Legaz; Fernández, Susana Soto; Escribano, Óscar; López-Jamar, José Miguel Esteban; Martin, C; Carrillo, Francisco Ruiz

doi:10.1111/j.1440-1746.2006.04375.x

Cited by 28 publications

(23 citation statements)

References 21 publications

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“…Little has been reported on rifabutin resistance in clinical practice. Eradication rates with a rifabutin-based regimen (rifabutin + amoxicillin + PPI) have been reported in the range of 62 -86% when used as salvage therapy after one or more previous eradication attempts [71][72][73] . A recent study using rifabutin triple therapy (rifabutin 150 mg b.i.d.…”

Section: Rifabutinmentioning

confidence: 99%

Helicobacter pylorieradication therapy: indications, efficacy and safety

Kwok

Lam

Katelaris

et al. 2008

Expert Opinion on Drug Safety

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Background : Helicobacter pylori infects up to half of the world's population. It remains the major cause of peptic ulcer disease and is recognised as a carcinogen for its role in gastric carcinogenesis. Successful eradication of the bacteria is associated with improved health outcomes including fewer dyspeptic symptoms, reduced peptic ulcer recurrence and rebleeding, reduced peptic ulcer risk with NSAIDs and as a cure for low-grade gastric MALT lymphoma. The risk of gastric cancer is reduced in those without premalignant mucosal abnormalities at the time of eradication. Objective : This review outlines the current indications and options for therapy of H. pylori with particular reference to drug-induced adverse events associated with treatment. Methods : The indications for H. pylori eradication are evidence-based and in accordance with recent consensus statements and recommendations. The eradication treatment is based on numerous clinical trials and meta-analyses. Results/conclusion : Eradication therapy, in general, is safe and well tolerated. Antibiotic therapy may be associated with significant drug adverse reactions, especially gastrointestinal symptoms.

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Section: Rifabutinmentioning

confidence: 99%

Helicobacter pylorieradication therapy: indications, efficacy and safety

Kwok

Lam

Katelaris

et al. 2008

Expert Opinion on Drug Safety

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“…Thus, until now, no rifabutin resistant strain has been isolated from patients who were either treated or untreated for H pylori infection [166] . As summarized Table 2, rifabutin-based rescue therapy constitutes an encouraging strategy after multiple previous eradication failures [63,72,130,149,[151][152][153]155,[169][170][171][172] . As an example, Perri et al [151,173] used a 1-wk regimen of PPI, amoxicillin and rifabutin in patients who were still H pylori infected after two or more courses of PPI-based triple therapies, and achieved an eradication rate of 71% by intention-to-treat analysis.…”

Section: Rifabutin-based Rescue Regimensmentioning

confidence: 99%

“…However, these encouraging results were not confirmed in a more recent study by these same authors [155] . In the largest study on rifabutin [170] , 92 consecutive patients diagnosed with H pylori infection resistant to two previous treatment regimens were treated with a PPI, rifabutin and amoxicillin for 10 d and the intention-to-treat eradication rate was 61%. In summary, the weighted mean eradication rate with rifabutin-based rescue therapy, calculated from the studies included in the Table 2, is 69%.…”

Section: Gisbert Jp Rescue Regimens For H Pylori 5393mentioning

confidence: 99%

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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Helicobacter pylori (H pylori ) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a "rescue" treatment depends on which treatment is used initially. If a clarithromycinbased regimen was used initially, a subsequent metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacinbased combination would be a third "rescue" option. Alternatively, it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, a quadruple regimen may be reserved as a third-line rescue option. Finally, rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H pylori eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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“…Another candidate for a third-line regimen is rifabutin (RFB). It is reported that RFB-based triple therapy is effective for H. pylori eradication in Spain [8]. RFB is an anti-tuberculosis agent derived from rifamycin-S and structurally similar to rifampicin (RFP), which is also a rifamycin-S derivative.…”

Section: Introductionmentioning

confidence: 99%

Past Rifampicin Dosing Determines Rifabutin Resistance of Helicobacter pylori

Suzuki

Nishizawa³

et al. 2009

Digestion

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Background: Recently, the number of Helicobacter pylori isolates showing antibiotic resistance has been increasing. Rifabutin (RFB) is one of the possible candidates for H. pylori eradication. In the present study, the RFB minimum inhibitory concentrations (MICs) and the resistance-determining genes to RFB (rpoB) were examined to clarify the relationship between drug MICs, rpoB mutations, and past history of rifampicin (RFP) treatment. Methods: The MICs of RFB and rpoB mutations were examined for 48 strains with failure of H. pylori eradication in the University Hospital and 46 isolated from patients at a specialized hospital for chronic respiratory diseases without past H. pylori eradication. Past RFP treatment was also examined. Results: Eight of 94 strains showed high RFB MICs and 6 of the 8 strains showed rpoB point mutations. Although no strains showed high RFB MICs among 48 strains from the patients in the University Hospital, all 7 strains isolated from patients with past RFP treatment showed high RFB MICs (≥0.12 mg/l). Conclusion: Although RFB might be a potential candidate component of a new H. pylori eradication regimen following the first- or second-line failure, it should be used after examining a past history of RFP treatment.

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

Cited by 28 publications

References 21 publications

Helicobacter pylorieradication therapy: indications, efficacy and safety

Helicobacter pylorieradication therapy: indications, efficacy and safety

“Rescue” regimens after Helicobacter pylori treatment failure

Past Rifampicin Dosing Determines Rifabutin Resistance of Helicobacter pylori

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