[Comparison of rifabutin- and levofloxacin-based third-line rescue therapies for Helicobacter pylori].
OBJECTIVE
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.
Department of Gastroenterology, Gachon Graduate School of Medicine, Gil Hospital, 1198, Namdong-gu, Incheon 405-760, Korea.
Myung Ho
MH
Jeong
Jun-Won
JW
Chung
Sang Jin
SJ
Lee
Minsu
M
Ha
Seok Hoo
SH
Jeong
Sunyoung
S
Na
Byung Soo
BS
Na
Sung Keun
SK
Park
Yoon Jae
YJ
Kim
Kwang An
KA
Kwon
Kwang Il
KI
Ko
Yunjeong
Y
Jo
Ki Baik
KB
Hahm
Hwoon-Yong
HY
Jung
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001944:Breath Tests; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D017828:Rifabutin / Q000627:therapeutic use*; D016879:Salvage Therapy
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D017828:Rifabutin; D064704:Levofloxacin; D000658:Amoxicillin; D015242:Ofloxacin