Rifabutin‐ and furazolidone‐based Helicobacter pylori eradication therapies after failure of standard first‐ and second‐line eradication attempts in dyspepsia patients

Abstract

SUMMARYBackground: Optimal management approach is not well defined for subjects who fail initial first-and second-line Helicobacter pylori eradication attempts and are dealt on a case-by-case basis by the specialists. Aim: To evaluate the efficacy and safety of standard and 'rescue' eradication therapies at primary and secondary care levels. Methods: H. pylori infected dyspepsia patients referred to our C13 urea breath testing laboratory between January 1999 to February 2002 were included. Eradication failure at secondary care level was treated using strategies including antibiotic sensitivity testing and the use of rifabutin-and furazolidone-based therapies. Results: 3280 patients received standard first-line eradication therapy, which was successful in 2530

“Rescue” regimens after Helicobacter pylori treatment failure

“…More recently, Treiber et al [145] investigated whether this quadruple regimen containing furazolidone could be effective as a third-line therapy in patients with H pylori treatment failure after firstline (clarithromycin-metronidazole ± amoxicillin) and second-line (PPI-bismuth-tetracycline-metronidazole) regimens, and H pylori infection was cured in up to 90% of the cases. Furthermore, a 7 d triple-regimen comprising furazolidone, amoxicillin and a PPI achieved an eradication rate of 60% in 10 patients who failed first-line, second-line and even rifabutin-based triple therapy [185] . A recent systematic review and meta-analysis of the effect of furazolidone-and nitrofurantoin-based regimens in the eradication of H pylori infection has been performed [186] .…”

“…Cure of H pylori was achieved in 90% of the patients nonresponsive to a second eradication trial, which gave a final eradication rate of 99%. In the study by Qasim et al [185] , 3280 patients received standard first-line eradication therapy, which was successful in 77% of the cases. Second-line therapy (bismuth-based quadruple) or triple therapy (altering constituent antibiotics) was successful in 56% of treated patients.…”

The Study of Association between Helicobacter pylori (H. pylori) and Chronic Obstructive Pulmonary Disease (COPD)

“…In conclusion, H. pylori infection may be associated with COPD. Further studies should be undertaken to clarify the potential underlying pathogenetic mechanisms [3]. Table 4 shows mean baseline values of spirometric parameters in H. pylori seropositive and seronegative non-COPD study subjects.…”

“…She said multiple regimens have been evaluated for Helicobacter pylori (H. pylori) therapy in randomized controlled trials [3,48,[75][76][77]. Despite the number of studies, the optimal therapeutic regimen has not yet been defined.…”

“…COPD remains frequent and costly disease representing one of the principal demands of the public health worldwide. Inhaled tobacco smoke and other noxious particles, such as occupational exposures and smoke from biomass fuels, are the most important exogenous factors that influence disease development and progression [3]. The most important bacterial causes of exacerbations of COPD are nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Chlamydia pneumonia [4].…”