An increase in antibiotic-resistant Helicobacter pylori strains after new triple therapy

Sato, Ryugo; Murakami, Kazushige; Kimoto, Mami; Fujioka, Toshio; Nasu, M

doi:10.1016/s0016-5085(98)80772-5

Cited by 2 publications

(1 citation statement)

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“…However, the likelihood of harbouring antibiotic‐resistant strains is very high in patients with multiple eradication failures, as demonstrated in several studies 15 , . 21 –23 Patient compliance to treatment is excellent and side‐effects are infrequent and mild. In this respect, this new regimen seems to be preferable to quadruple therapy which has been proposed as second‐line treatment in eradication failures after standard triple therapy 24 .…”

Section: Discussionmentioning

confidence: 99%

Rifabutin‐based ‘rescue therapy’ for Helicobacter pylori infected patients after failure of standard regimens

Perri¹,

Festa²,

Clemente³

et al. 2000

Aliment Pharmacol Ther

129

109

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The ideal therapy to cure Helicobacter pylori is still lacking. Currently recommended eradication treatments are based on drug combinations in which an antisecretory drug (or ranitidine bismuth citrate) is administered with two of the following: clarithromycin, nitroimidazoles, tetracycline, and amoxycillin.1 In case of treatment failure, either a second course of triple regimen or a quadruple therapy (proton-pump inhibitor plus bismuth-based triple therapy) has been proposed.2 Until now, however, these regimens have been used as second-line therapies in a few patients and seem to be less effective than when used as ®rst-line treatments. 3±9 Therefore, new alternative strategies are needed.10 Preliminary studies have shown that H. pylori is highly susceptible in vitro to rifabutin, a spiropiperidyl derivative of rifamycin-S. 11 The aim of this study was to assess the ef®cacy and tolerability of rifabutin in infected patients who failed two or more courses of standard proton pump inhibitor-based triple regimens. PATIENTS AND METHODSThis open single-centre pilot study was conducted in Italy in 1997. Patients who were still H. pylori-positive on 13 C-urea breath test after at least two courses of SUMMARY Background: The ideal treatment for patients who have failed eradication of Helicobacter pylori infection after standard proton pump inhibitor-based triple therapies has still to be determined. Although either a second course of triple therapy or a quadruple therapy (proton pump inhibitor plus bismuth-based triple therapy) has been proposed, the ef®cacy of these second-line therapies is relatively unknown. Therefore, alternative strategies are needed. Aim: To assess the ef®cacy and tolerability of rifabutin, a derivative of rifamycin-S, in patients who were still H. pylori infected after two or more courses of 1-week triple therapies. Methods: Patients were given a 1-week regimen of pantoprazole 40 mg b.d. + amoxycillin 1 g b.d. + rifa-

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