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J. Clin. Med. 2019, 8(2), 199; https://doi.org/10.3390/jcm8020199

Rifabutin-Based Rescue Therapy for Helicobacter pylori Eradication: A Long-Term Prospective Study in a Large Cohort of Difficult-to-Treat Patients

1
Department of Surgical Sciences, University of Turin, 10123 Turin, Italy
2
Institute of Biostructure and Bioimaging (CNR) c/o Molecular Biotechnology Center, 10126 Turin, Italy
3
Unit of Gastroenterology, Molinette Hospital, 10123 Turin, Italy
4
Department of Medical Sciences, University of Turin, 10123 Turin, Italy
5
Unit of Gastroenterology, Maria Vittoria Hospital, 10100 Turin, Italy
*
Authors to whom correspondence should be addressed.
Received: 29 December 2018 / Revised: 30 January 2019 / Accepted: 2 February 2019 / Published: 6 February 2019
(This article belongs to the Section Gastroenterology & Hepato-Pancreato-Biliary Medicine)
Full-Text   |   PDF [227 KB, uploaded 6 February 2019]

Abstract

The most commonly used regimens fail to eradicate Helicobacter pylori (H. pylori) infection in 5–10% of patients. Those not cured with treatments based on amoxicillin, clarithromycin, nitroimidazoles, fluoroquinolones, bismuth or tetracycline have no other conventional options thereafter. In this prospective long-term monocentric study, patients who failed to eradicate H. pylori following treatment with all conventional antibiotics were included. All subjects were treated with rifabutin 150 mg, amoxicillin 1 g and a standard dose of proton pump inhibitor, twice daily for 14 days. A negative 13C-urea breath test was used four weeks after treatment completion as an index of H. pylori eradication. Three hundred and two patients were included. Fifty-four percent (164/302) had peptic ulcer disease while 45.7% (138/302) had gastritis or functional dyspepsia. Per-protocol eradication and intention-to-treat eradication were achieved in 72.7% and 71.5%, respectively. A univariate analysis showed that gender, ethnic background, smoking habits and familial history of gastric diseases were not predictive factors of response, while with multiple logistic regression analysis, the ethnic background (Italian) predicted a poor response in the second period of the study (2010–2017). In conclusion, this study on a large cohort of very difficult-to-treat patients showed that rifabutin-based rescue therapy is an acceptable and safe strategy after multiple eradication failures with conventional antibiotics. View Full-Text
Keywords: rifabutin; Helicobacter pylori; gastritis; peptic ulcer; dyspepsia; gastric cancer rifabutin; Helicobacter pylori; gastritis; peptic ulcer; dyspepsia; gastric cancer
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Ribaldone, D.G.; Fagoonee, S.; Astegiano, M.; Durazzo, M.; Morgando, A.; Sprujevnik, T.; Giordanino, C.; Baronio, M.; De Angelis, C.; Saracco, G.M.; Pellicano, R. Rifabutin-Based Rescue Therapy for Helicobacter pylori Eradication: A Long-Term Prospective Study in a Large Cohort of Difficult-to-Treat Patients. J. Clin. Med. 2019, 8, 199.

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