Rifamycin Use for Treatment of
            <i>Helicobacter Pylori</i>
            Infection: A Review of Recent Data

Boyanova, Lyudmila; Markovska, Rumyana; Hadzhiyski, Petyo; Kandilarov, Nayden; Mitov, Ivan

doi:10.2217/fmb-2020-0084

Cited by 11 publications

(21 citation statements)

References 60 publications

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“…Compared with other rifamycin, rifaximin does not seem to show the same effect. 8 A similar situation occurs when furazolidone, another non-absorbable antibacterial agent, was used to eradicate H. pylori . 26 The mechanism is unclear yet, the possible explanation may be that non-absorbable antibiotics are lack of the gastric mucosal transfer process, may reduce the duration of H. pylori exposed to the agents, resulting in insufficient eradication efficacy.…”

Section: Discussionmentioning

confidence: 94%

“…The resistance rate to rifaximin is less reported than that of other rifamycins, and is mainly reported by some countries in Asia (Bangladesh, Indonesia, Nepal), from 30% to 65%. 8 However, there are no reports in Europe and Korea and the results may partly reflect the differences of resistance rates. In addition, adults from four European countries were from Eastern and Southern Europe and the result may not reflect the situation in Western and Northern Europe, where H. pylori resistance to antimicrobial drugs is lower traditionally.…”

Section: Discussionmentioning

confidence: 99%

“…It may also reduce virulence factors and the morphology of bacteria, inhibit bacterial attachment, and decrease the mucosal inflammatory response. 7 , 8 Based on these features, it is widely used in the treatment of local infections such as diarrhea and cirrhosis now, rather than systematic infection or infections from other sites but gastrointestinal tract. The less-frequent applications of rifaximin may reduce the resistance rate to H. pylori .…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Wang¹,

Tang²,

Zhou³

et al. 2022

IDR

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Background Rifaximin, a rifamycin antibiotic, is widely used to treat infectious diarrhea but not commonly used in H. pylori eradication. With its potential advantages of the agent, some studies were conducted on this topic. The aim of this study is to assess effectiveness and safety of rifaximin-containing regimens and to evaluate whether they are alternative choices for H. pylori eradication. Methods Scientific databases including PubMed, EMbase and Cochrane Library were used to identify clinical trials on rifaximin-containing regimens published from January 2000 to October 2021. Review Manager 5.4 and STATA12 were adopted for the systematic review. Results In this study, totally 1025 patients were included from 3 randomized controlled and 9 single-arm studies. It showed that the differences in effectiveness and safety between rifaximin-containing and first-line regimens were not statistically significant in randomized controlled trials. However, the results of the single-arm trials indicated that the eradication and adverse drug reaction rate varied suggesting data instability ( r =38.1%-85.4%, r ADR 0.00–67.5% by ITT analysis). Among them, the eradication rate of pediatric patients ( r =85.4% by ITT analysis) was higher than that of adult patients ( r =38.1–74.5% by ITT analysis). Meanwhile, in all adult subgroups (triple or quadruple, with or without amoxicillin, different duration and rifaximin dose), the results did not show sufficient effectiveness as all the eradication rates did not meet the minimum ideal or ideal target. Conclusion Taken together, rifaximin-containing regimens should not be recommended for H. pylori eradication as they cannot achieve the eradication rate desired.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Wang¹,

Tang²,

Zhou³

et al. 2022

IDR

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“…Type of previous (failed) H. pylori eradication treatment varied markedly depending on the study, but in most of the cases included a first-line treatment with a PPI, clarithromycin, and either amoxicillin or nitroimidazole. Clinical experience with rifabutin for treatment of H. pylori infection has focused mainly on patients in whom one or more courses of anti-H pylori treatment previously failed [7][8][9][109][110][111]. However, three recent studies evaluated the role of rifabutin in H. pylori treatment naïve patients [77,103,107].…”

Section: Efficacy Of Rifabutin For H Pylori Eradicationmentioning

confidence: 99%

Rifabutin for the Treatment of Helicobacter pylori Infection: A Review

Gisbert¹

2020

Pathogens

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Nowadays, apart from having to know first-line Helicobacter pylori eradication regimens well, we must also be prepared to face treatment failures. The aim of this review is to summarize the role of rifabutin in the management of H. pylori infection. Bibliographical searches were performed in PubMed. Data on resistance and efficacy of rifabutin-containing regimens on H. pylori eradication were meta-analyzed. Mean H. pylori rifabutin resistance rate (39 studies, including 9721 patients) was 0.13%; when studies only including patients naïve to H. pylori eradication treatment were considered, this figure was even lower (0.07%). Mean H. pylori eradication rate (by intention-to-treat) with rifabutin-containing regimens (3052 patients) was 73%. Respective cure rates for second-, third-, fourth- and fifth-line therapies, were 79%, 69%, 69% and 72%. Most studies administered rifabutin 300 mg/day, which seemed to be more effective than 150 mg/day. The ideal length of treatment remains unclear, but 10–12-day regimens are generally recommended. Adverse events to rifabutin treatment in H. pylori studies were relatively infrequent (15%), and severe adverse events were exceptional (myelotoxicity was the most significant, although always reversible). In summary, rifabutin-containing therapy represents an encouraging strategy generally restricted, at present, to patients where previous (usually multiple) eradication regimens have failed.

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“…Given the complex interplay between H. pylori infection, SIBO and PD, ideally the employed antibiotic agent would eradicate H. pylori in addition to TDC-producing Enterococcus and Lactobacillus spp . The efficacy of rifaximin monotherapy for H. pylori eradication, however, is disappointing 69 , whereas the effect of vancomycin is non-existent ( H. pylori being Gram-negative). The standard regimen for H. pylori eradication is a combination therapy which, depending on regional antibiotic resistance, entails either a triple therapy, consisting of a proton-pump inhibitor, clarithromycin and amoxicillin, or a quadruple therapy, comprised of a proton-pump inhibitor, bismuth, metronidazole and tetracycline 70 .…”

Section: Further Research and Possible Therapeutic Interventionsmentioning

confidence: 99%

Mechanisms of peripheral levodopa resistance in Parkinson’s disease

Beckers

Bloem

Verbeek

2022

npj Parkinsons Dis.

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Parkinson’s disease (PD) is an increasingly common neurodegenerative condition. The disease has a significant negative impact on quality of life, but a personalized management approach can help reduce disability. Pharmacotherapy with levodopa remains the cornerstone of treatment, and a gratifying and sustained response to this treatment is a supportive criterion that argues in favor of an underlying diagnosis of PD. Yet, in daily practice, it is not uncommon to encounter patients who appear to have true PD, but who nevertheless seem to lose the responsiveness to levodopa (secondary non-responders). Some patients may even fail to respond altogether (primary non-responders). Here, we address how two mechanisms of “peripheral resistance” may underlie this failing response to levodopa in persons with PD. The first explanation relates to impaired bowel motility leading to secondary bacterial overgrowth, and more specifically, to the excessive bacterial production of the enzyme tyrosine decarboxylase (TDC). This enzyme may convert levodopa to dopamine in the gut, thereby hampering entry into the circulation and, subsequently, into the brain. The second explanation relates to the systemic induction of the enzyme aromatic l-amino acid decarboxylase (AADC), leading to premature conversion of levodopa into dopamine, again limiting the bioavailability within the brain. We discuss these two mechanisms and focus on the clinical implications, potential treatments and directions for future research.

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Rifamycin Use for Treatment of Helicobacter Pylori Infection: A Review of Recent Data

Cited by 11 publications

References 60 publications

Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Rifabutin for the Treatment of Helicobacter pylori Infection: A Review

Mechanisms of peripheral levodopa resistance in Parkinson’s disease

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