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Rifabutin-based High-dose Proton-pump Inhibitor and Amoxicillin Triple Regimen as the Rescue treatment for Helicobacter pylori

Authors
 Hyun Chul Lim  ;  Yong Jae Lee  ;  Byoungrak An  ;  Seung Woo Lee  ;  Yong Chan Lee  ;  Byung Soo Moon 
Citation
 HELICOBACTER, Vol.19(6) : 455-461, 2014 
Journal Title
 HELICOBACTER 
ISSN
 1083-4389 
Issue Date
2014
MeSH
Adult ; Aged ; Amoxicillin/administration & dosage* ; Amoxicillin/adverse effects ; Anti-Bacterial Agents/administration & dosage* ; Anti-Bacterial Agents/adverse effects ; Drug Administration Schedule ; Drug Resistance, Bacterial ; Drug Therapy, Combination/adverse effects ; Female ; Helicobacter Infections/drug therapy* ; Helicobacter Infections/microbiology ; Helicobacter pylori/drug effects* ; Helicobacter pylori/physiology ; Humans ; Male ; Prospective Studies ; Proton Pump Inhibitors/administration & dosage* ; Proton Pump Inhibitors/adverse effects ; Republic of Korea ; Rifabutin/administration & dosage* ; Rifabutin/adverse effects ; Treatment Outcome
Keywords
Rifabutin ; amoxicillin ; high-dose proton-pump inhibitor ; third-line recue therapy
Abstract
BACKGROUND: Rifabutin has been known to be effective in multidrug-resistant Helicobacter pylori-harboring patients undergoing treatment failure for H. pylori infection. AIM: To evaluate the efficacy of 7-day treatment regimen consisting rifabutin daily but increasing the dose of amoxicillin and lansoprazole in patients who have failed first and second eradication and to assess the side effect profiles in South Korea. METHODS: From December 2007 to May 2013, 59 H. pylori-infected patients with two previous eradication failures were enrolled for this study prospectively. The eligible patients were randomly assigned to either group A or B. Group A received lansoprazole 30 mg bid, amoxicillin 1.0 g tid and rifabutin 150 mg bid during 7 days, whereas group B received lansoprazole 60 mg bid, amoxicillin 1.0 g tid and rifabutin 150 mg bid during 7 days. RESULTS: In group A, H. pylori eradication was achieved in 25 (78.1%) of the 32 patients in the ITT analysis and in 25 (80.6%) of the 31 patients in the PP analysis. In group B, H. pylori eradication was achieved in 26 (96.3%) of the 27 patients in the ITT analysis and in 27 (100%) of the 26 patients in the PP analysis. There was statistically significant difference between the two groups in terms of the eradication rates in PP analysis (p = .047), whereas a marginally statistical significance was found in terms of the eradication rates in ITT analysis (p = .051). Reported side effects were mild, and treatment was well tolerated. No major changes in physical examination or in standard laboratory parameters were observed after treatment. CONCLUSIONS: Rifabutin-based high-dose proton-pump inhibitor (PPI)-combined therapy as empirical rescue treatment is more effective than standard dose PPI-combined rifabutin-based therapy, safe and best tolerable in third-line therapy in the Korean population. The key to successful rescue therapy with rifabutin-amoxicillin-PPI regimen may be to increase doses of PPI.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/hel.12147/abstract
DOI
10.1111/hel.12147
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Byung Soo(문병수)
Yi, Seung Woo(이승우) ORCID logo https://orcid.org/0000-0002-5929-9444
Lee, Yong Jae(이용제) ORCID logo https://orcid.org/0000-0002-6697-476X
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lim, Hyun Chul(임현철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100385
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