Korean J Gastroenterol.  2012 Jun;59(6):401-406. 10.4166/kjg.2012.59.6.401.

Comparison of Rifabutin- and Levofloxacin-based Third-line Rescue Therapies for Helicobacter pylori

• Jeong MH
• Chung JW
• Lee SJ
• Ha M
• Jeong SH
• Na S
• Na BS
• Park SK
• Kim YJ
• Kwon KA
• Ko KI
• Jo Y
• Hahm KB
• Jung HY

• KMID: 1792844
• DOI: http://doi.org/10.4166/kjg.2012.59.6.401

Abstract

BACKGROUND/AIMS
There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures.
METHODS
Patients, in whom a first treatment with proton pump inhibitor-clarithromycin-amoxicillin and a second trial with proton pump inhibitor-bismuth-tetracycline-metronidazole had failed, received treatment with either rifabutin or levofloxacin, plus amoxicillin (1 g twice daily) and standard dose proton pump inhibitor. Eradication rates were confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy.
RESULTS
Eradication rates were 71.4% in the rifabutin group, and 57.1% in the levofloxacin group, respectively. Although there was no significant difference in Helicobacter pylori eradication rates between two groups (p=0.656), rifabutin based regimen showed relatively higher eradication rate.
CONCLUSIONS
Helicobacter pylori eradication rates of rifabutin- or levofloxacin-based triple therapy could not achieve enough eradication rate. Further studies would be needed on combination of levofloxacin and rifabutin-based regimen or culture based treatment.

Keyword

Helicobacter pylori; Rifabutin; Levofloxacin; Third line; Salvage therapy

MeSH Terms

Adult
Aged
Aged, 80 and over
Amoxicillin/therapeutic use
Anti-Bacterial Agents/*therapeutic use
Breath Tests
Drug Resistance, Bacterial/drug effects
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy
Helicobacter pylori
Humans
Male
Middle Aged
Ofloxacin/*therapeutic use
Proton Pump Inhibitors/therapeutic use
Rifabutin/*therapeutic use
Salvage Therapy

Figure

• 

  Fig. 1 The flow chart for eradication of Helicobacter pylori. PPI, proton pump inhibitor.

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