Past rifampicin dosing determines rifabutin resistance of Helicobacter pylori.
BACKGROUND
Recently, the number of Helicobacter pylori isolates showing antibiotic resistance has been increasing. Rifabutin (RFB) is one of the possible candidates for H. pylori eradication. In the present study, the RFB minimum inhibitory concentrations (MICs) and the resistance-determining genes to RFB (rpoB) were examined to clarify the relationship between drug MICs, rpoB mutations, and past history of rifampicin (RFP) treatment.


METHODS
The MICs of RFB and rpoB mutations were examined for 48 strains with failure of H. pylori eradication in the University Hospital and 46 isolated from patients at a specialized hospital for chronic respiratory diseases without past H. pylori eradication. Past RFP treatment was also examined.


RESULTS
Eight of 94 strains showed high RFB MICs and 6 of the 8 strains showed rpoB point mutations. Although no strains showed high RFB MICs among 48 strains from the patients in the University Hospital, all 7 strains isolated from patients with past RFP treatment showed high RFB MICs (>or=0.12 mg/l).


CONCLUSIONS
Although RFB might be a potential candidate component of a new H. pylori eradication regimen following the first- or second-line failure, it should be used after examining a past history of RFP treatment.
Suzuki
Shoji
S
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Suzuki
Hidekazu
H
Nishizawa
Toshihiro
T
Kaneko
Fumihiko
F
Ootani
Sumire
S
Muraoka
Hiroe
H
Saito
Yoshimasa
Y
Kobayashi
Intetsu
I
Hibi
Toshifumi
T
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D017828:Rifabutin / Q000494:pharmacology*; D012293:Rifampin / Q000008:administration & dosage / Q000494:pharmacology; D017211:Treatment Failure
D000900:Anti-Bacterial Agents; D017828:Rifabutin; D012321:DNA-Directed RNA Polymerases; D012293:Rifampin