Efficacy and safety of rifabutin-containing ‘rescue therapy’ for resistant Helicobacter pylori infection



This article is corrected by:

  1. Errata: Errata Volume 24, Issue 2, 439, Article first published online: 26 June 2006

Dr T. J. Borody, Centre for Digestive Disease, 144, Great North Road, Five Dock, NSW 2046, Australia.
E-mail: tborody@zip.com.au


Background  Current ‘rescue’ therapies provide inadequate Helicobacter pylori eradication rates because of antibiotic resistance.

Aim  To test the efficacy of a modified triple regimen combining rifabutin, pantoprazole and amoxicillin as rescue therapy for patients in whom eradication of H. pylori had failed standard clarithromycin-based triple therapy.

Methods  One hundred and thirty patients (mean age 51.7 ± 14.8 years) who had failed one or more eradication attempts with omeprazole, clarithromycin and amoxicillin were treated for 12 days with rifabutin 150 mg daily, amoxicillin 1 g or 1.5 g t.d.s, and pantoprazole 80 mg t.d.s.

Results  The intention-to-treat and per-protocol eradication rates were 90.8/90.8%. Metronidazole or/and clarithromycin resistance had no significant impact on H. pylori eradication rates. A higher overall eradication rate of 96.6% (95% CI: 92.1–101%) was obtained in patients treated with a regimen containing 1.5 g amoxicillin t.d.s compared with 90.7% (95% CI: 82–98.6%) using a regimen with 1 g amoxicillin t.d.s but the difference was not significant. Side-effects reported in 40% of patients were mild.

Conclusion  A 12-day course of low dose of rifabutin with an increased dose of amoxicillin and pantoprazole is well-tolerated and highly effective against dual-resistant H. pylori infection after failure of triple therapy.