Abstract
BackgroundThere is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori). This aim of this study was to investigate the efficacy of rifabutin-based triple therapy for patients infected with dual drug-resistant strains to clarithromycin and levofloxacin.MethodsAfter 2 or 3 H. pylori treatment failures, patients underwent upper endoscopy with tissue biopsies. Phenotypic and genotypic resistances were determined using agar dilution test and polymerase chain reaction with direct sequencing, respectively. Patients infected with dual drug-resistant (clarithromycin and levofloxacin) strains and receiving rifabutin-based triple therapy (rifabutin 150 mg bid, amoxicillin 1 g bid and esomeprazole 40 mg bid for 10 days) were enrolled. Eradication status was determined by 13C-urea breath test 4 weeks after treatment completion.ResultsA total of 39 patients infected with dual drug-resistant strains were enrolled in this study, with a mean age of 55.9 years. The eradication rate was 79.5% (31/39) (95% confidence intervals: 54.96% ~ 111.40%). Adverse event was reported in 23.1% (9/39) of patients but they were mild and tolerable. In univariate analysis, no factor was identified as an independent predictor of eradication failure.ConclusionsOur current study demonstrated that rifabutin-based triple therapy was well tolerated and yielded an acceptable eradication rate for patients infected with dual drug-resistant strains of H. pylori.
Highlights
There is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori)
The Maastricht IV/Florence consensus report suggests that culture and antimicrobial sensitivity testing should be performed when designing a treatment strategy after one or two treatment failures with different antibiotics [3]
The aim of the present study was to evaluate the efficacy of rifabutin regimen in patients infected with H. pylori dual resistant to clarithromycin and levofloxacin
Summary
There is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori). This aim of this study was to investigate the efficacy of rifabutin-based triple therapy for patients infected with dual drug-resistant strains to clarithromycin and levofloxacin. In areas of low clarithromycin resistance, clarithromycin-based triple therapy is. Rifabutin, which mostly used against Mycobacterium tuberculosis and Mycobacterium avium intracellulare infection, has been applied as an alternative regimen for H. pylori eradication [8,9,10]. The aim of the present study was to evaluate the efficacy of rifabutin regimen in patients infected with H. pylori dual resistant to clarithromycin and levofloxacin
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