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Rifabutin Rescue Therapy Effective After Helicobacter Eradication Failures
A DGReview of :"'Rescue' Therapy with Rifabutin after Multiple Helicobacter pylori Treatment Failures"
Helicobacter
04/16/2003
By David Loshak
Rescue therapy based on the anti-mycobacterial drug rifabutin offers an "encouraging" rescue therapy after other agents have failed to eradicate Helicobacter pylori.
A rifabutin-based combination is a promising strategy after such key antibiotics as amoxicillin, clarithromycin, metronidazole and tetracycline have not countered the organism, report gastroenterological researchers in Madrid, Barcelona and Baracaldo, Spain. They pointed out that although eradication therapy using a proton pump inhibitor, clarithromycin or amoxicillin was widely used, it did often fail.
Rescue therapy combining omeprazole, bismuth, tetracycline and metronidazole (or ranitidine bismuth citrate with these same antibiotics) had been recommended but even this did not work in a fifth of cases. The researchers, therefore, used a prospective multi-centre study to evaluate the efficacy and tolerability of a rifabutin-based regimen in 14 patients who had experienced consecutive H. pylori eradication failures on those two regimens. The patients were aged 42 ± 11 years, six were men. Eight patients had peptic ulcer and six had dyspepsia. All completed the study protocol.
This third eradication regimen consisted of twice-daily rifabutin 150 mg. amoxicillin 1.0 gram and omeprazole 20 mg. for 14 days. All drugs were administered together after breakfast and dinner.
Adherence to therapy was determined from questioning patients and from the recovery of empty envelopes of medications.
The researchers defined H. pylori eradication as a negative 13C-urea breath test eight weeks after completing the treatment.
Per-protocol and intention-to-treat eradication was achieved in 11 cases. Five had adverse effects such as abdominal pain, nausea and vomiting and oral candidiasis but none stopped treatment as a result.
http://www.docguide.com/news/content.nsf/WebOpenPaper_TopAbstracts"OpenAgent&newsid=8525697700573E1885256CF90036565E" 'Rescue' Therapy with Rifabutin after Multiple Helicobacter pylori Treatment Failures 2003-03-31 Helicobacter
Helicobacter 2003;8:2:90-94.
"'Rescue' Therapy with Rifabutin after Multiple Helicobacter pylori Treatment Failures"
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