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Jeong, Chung, Lee, Ha, Jeong, Na, Na, Park, Kim, Kwon, Ko, Jo, Hahm, and Jung: Comparison of Rifabutin- and Levofloxacin-based Third-line Rescue Therapies for Helicobacter pylori
Original Article
Alimentary Tract
The Korean Journal of Gastroenterology

The Korean Journal of Gastroenterology 2012; 59(6): 401-406.

Published online: 20 June 2012

DOI: https://doi.org/10.4166/kjg.2012.59.6.401

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

Myung Ho Jeong, Jun-Won Chung, Sang Jin Lee, Minsu Ha, Seok Hoo Jeong, Sunyoung Na, Byung Soo Na, Sung Keun Park, Yoon Jae Kim, Kwang An Kwon, Kwang Il Ko, Yunjeong Jo, Ki Baik Hahm, Hwoon-Yong Jung1

Department of Internal Medicine, Gachon Graduate School of Medicine, Incheon, Korea.

1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence to: Jun-Won Chung, Department of Gastroenterology, Gachon Graduate School of Medicine, Gil Hospital, 1198, Namdong-gu, Incheon 405-760, Korea. Tel: +82-32-460-2622, Fax: +82-32-460-3431, drgreen@gilhospital.com

Received 12 July 2011       Revised 26 September 2011       Accepted 30 September 2011

Copyright © 2012 The Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Helicobacter pylori, Rifabutin, Levofloxacin, Third line, Salvage therapy

Figures and Tables

Fig. 1
The flow chart for eradication of Helicobacter pylori. PPI, proton pump inhibitor.
kjg-59-401-g001
Table 1
Baseline Characteristics of Patients
kjg-59-401-i001

Values are presented as n (range).

M, male; F, female; ESD, endoscopic submucosal dissection; MALT, mucosa-associated lymphoid tissue.

Table 2
Results of Third-line Two Regimens for Eradication of Helicobacter pylori
kjg-59-401-i002

Notes

Financial support: None.

Conflict of interest: None.

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