Rescue therapies for Helicobacter pylori infection after failure of proton pump inhibitor-based standard triple therapy.
- Author:
Young Hwan SEO
1
;
Su Yeon RHIE
;
Bum Joon PARK
;
Hyung Joon KIM
;
Jae Gyu KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. jgkimd@cau.ac.kr
- Publication Type:Original Article
- Keywords:
Helicobacter pylori;
Second line therapy;
Rescue therapy
- MeSH:
Amoxicillin;
Biopsy;
Bismuth;
Breath Tests;
Carbamates;
Endoscopy;
Helicobacter;
Helicobacter pylori;
Humans;
Organometallic Compounds;
Proton Pumps;
Protons;
Rifabutin;
Tetracycline;
Urea;
Urease
- From:Korean Journal of Medicine
2008;74(1):23-29
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Proton pump inhibitor (PPI)-based standard triple therapy for Helicobacter pylori infection is widely used, but it has a considerable failure rate. The aim of this study was to evaluate the efficacy and tolerability of rescue therapies with a quadruple regimen and a rifabutin-based regimen for patients who experienced failure with PPI-based standard triple therapy. METHODS: From July 2004 through October 2006, 52 patients for whom first line triple therapy (PPI, amoxicillin and clarithromycin) had failed were included in this study. They were treated with a quadruple regimen for 7 days (PPI, bismuth, tetracycline and metronidazole) as a second line therapy. For third line therapy, a rifabutin-based regimen (PPI, rifabutin and amoxicillin) was prescribed for 14 days. The H. pylori status was determined before and at least 4 weeks after therapy by the 13C urea breath test or by endoscopy with antral and corpus biopsies for a rapid urease test, histological examination and culture. RESULTS: The mean age was 52.6 years. Thirteen patients (25%) of the 52 patients were dropped. The eradication rate of the quadruple therapy was 84.6% (33/39). Three patients of the 6 failures with quadruple therapy were then treated with the rifabutin-based regimen. The eradication rate of the rifabutin-based therapy was 100% (3/3). Adverse effects (10.2%) were reported in 4 patients who were treated with quadruple regimen. CONCLUSIONS: The quadruple regimen is still an effective second-line therapy for Korean patients who experience failure with PPI-based standard triple therapy. The rifabutin-based regimen could be used as a third-line rescue therapy in Korea.
