Efficacy and safety of low‐dose rifabutin‐based 7‐day triple therapy as a third‐ or later‐lineHelicobacter pylorieradication regimen
Abstract
Abstract Background Rifabutin‐based regimens are used as rescue therapy for refractoryHelicobacter pyloriinfection; however, the duration for which treatment is required and side effects are concerning. This study assessed the efficacy and safety of 7‐day rifabutin, amoxicillin, and vonoprazan triple therapy as third‐ or later‐line treatment forH. pyloriinfection. Materials and Methods Patients who did not respond to second‐line therapy were enrolled. AfterH. pyloriinfection was confirmed with the culture method, the patients received rifabutin‐containing triple therapy (20 mg vonoprazan b.i.d., 500 mg amoxicillin q.i.d., and 150 mg rifabutin q.d.) for 7 days. Twelve weeks after the eradication therapy, successful eradication was confirmed using a13C urea breath test or theH. pyloristool antigen test. The results obtained from our previous study that reported a 10‐day or 14‐day esomeprazole based rifabutin‐containing triple therapy as a third‐ or fourth‐line rescue therapy treated patients were used as historical control. We determined the minimum inhibitory concentrations of amoxicillin and rifabutin. We also evaluated whether the patients were positive for the mutation of therpoBgene. Results Intention‐to‐treat and per‐protocol analyses showed that our regimen resulted in a high eradication rate (91.2%, 95% CI: 84%–99% and 92.7%, 95% CI: 86%–100%, respectively). Adverse events occurred in 31.6% of the patients, and two patients discontinued the therapy. Conclusions This is…
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