Rifabutin-based triple therapy after failure of Helicobacter pylori eradication treatment - Preliminary experience

Despite continuous improvement of Helicobacter pylori (Hp) eradication ther apy, new treatment regimens are necessary if established first-line treatme nts fail. In the present pilot study, a recently described rifabutin-based triple therapy was evaluated after preceding failure of triple therapy. Rif abutin (150 mg), amoxicillin (1 g), and lansoprazole (30 mg) were administe red twice daily for 1 week to 25 patients infected with lip who had previou sly failed to respond to eradication treatment and/or who had developed res istance to macrolides and nitroimidazoles. Four patients were lost to follo w-up. Eradication rate of rifabutin-based triple therapy was 86% (18/21; pe rprotocol) and 72% (18/25; intention-to-treat). Side effects were minimal. It is concluded that this new drug combination is an effective therapy for Hp strains resistant to clarithromycin or metronidazole; however, rifabutin -based treatment regimens for Hp eradication should be restricted to patien ts infected with resistant strains.