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Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties

When several Helicobacter pylori eradication treatments fail, guidelines recommend a cultured guided approach; however, culture is not widely available. Therefore, a rifabutin based regimen could be the best solution. Rifabutin indeed shows a low rate of antibiotic resistance. Rifabutin is generally...

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Autores principales: Borraccino, Antonia Valeria, Celiberto, Francesca, Pricci, Maria, Girardi, Bruna, Iannone, Andrea, Rendina, Maria, Ierardi, Enzo, Di Leo, Alfredo, Losurdo, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753051/
https://www.ncbi.nlm.nih.gov/pubmed/36533106
http://dx.doi.org/10.3748/wjg.v28.i45.6356
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author Borraccino, Antonia Valeria
Celiberto, Francesca
Pricci, Maria
Girardi, Bruna
Iannone, Andrea
Rendina, Maria
Ierardi, Enzo
Di Leo, Alfredo
Losurdo, Giuseppe
author_facet Borraccino, Antonia Valeria
Celiberto, Francesca
Pricci, Maria
Girardi, Bruna
Iannone, Andrea
Rendina, Maria
Ierardi, Enzo
Di Leo, Alfredo
Losurdo, Giuseppe
author_sort Borraccino, Antonia Valeria
collection PubMed
description When several Helicobacter pylori eradication treatments fail, guidelines recommend a cultured guided approach; however, culture is not widely available. Therefore, a rifabutin based regimen could be the best solution. Rifabutin indeed shows a low rate of antibiotic resistance. Rifabutin is generally used in combination with amoxicillin in a triple therapy, with eradication rates about 80% in third-line regimens. The ideal duration of this therapy should range between 10 and 12 d. Combinations with antibiotics other than amoxicillin have demonstrated even better results, such as vonoprazan, which is a type of novel acid suppressor drug. Finally, a new formulation of triple therapy in a single capsule is under investigation, which is a field that deserves further investigation. Some notes of caution about rifabutin should be mentioned. This drug is used to treat tuberculosis or atypical mycobacteria; therefore, before starting a rifabutin-based eradication regimen, Mycobacterium tuberculosis infection should be thoroughly tested, since its use could promote the development of antibiotic resistance, thus affecting its effectiveness against Koch’s bacillus. Additionally, some serious side effects must be evaluated before starting any rifabutin-based therapy. Adverse effects include fever, nausea, vomiting and bone marrow suppression. For this reason, full blood count surveillance is required.
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spelling pubmed-97530512022-12-16 Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties Borraccino, Antonia Valeria Celiberto, Francesca Pricci, Maria Girardi, Bruna Iannone, Andrea Rendina, Maria Ierardi, Enzo Di Leo, Alfredo Losurdo, Giuseppe World J Gastroenterol Minireviews When several Helicobacter pylori eradication treatments fail, guidelines recommend a cultured guided approach; however, culture is not widely available. Therefore, a rifabutin based regimen could be the best solution. Rifabutin indeed shows a low rate of antibiotic resistance. Rifabutin is generally used in combination with amoxicillin in a triple therapy, with eradication rates about 80% in third-line regimens. The ideal duration of this therapy should range between 10 and 12 d. Combinations with antibiotics other than amoxicillin have demonstrated even better results, such as vonoprazan, which is a type of novel acid suppressor drug. Finally, a new formulation of triple therapy in a single capsule is under investigation, which is a field that deserves further investigation. Some notes of caution about rifabutin should be mentioned. This drug is used to treat tuberculosis or atypical mycobacteria; therefore, before starting a rifabutin-based eradication regimen, Mycobacterium tuberculosis infection should be thoroughly tested, since its use could promote the development of antibiotic resistance, thus affecting its effectiveness against Koch’s bacillus. Additionally, some serious side effects must be evaluated before starting any rifabutin-based therapy. Adverse effects include fever, nausea, vomiting and bone marrow suppression. For this reason, full blood count surveillance is required. Baishideng Publishing Group Inc 2022-12-07 2022-12-07 /pmc/articles/PMC9753051/ /pubmed/36533106 http://dx.doi.org/10.3748/wjg.v28.i45.6356 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Minireviews
Borraccino, Antonia Valeria
Celiberto, Francesca
Pricci, Maria
Girardi, Bruna
Iannone, Andrea
Rendina, Maria
Ierardi, Enzo
Di Leo, Alfredo
Losurdo, Giuseppe
Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title_full Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title_fullStr Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title_full_unstemmed Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title_short Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties
title_sort rifabutin as salvage therapy for helicobacter pylori eradication: cornerstones and novelties
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753051/
https://www.ncbi.nlm.nih.gov/pubmed/36533106
http://dx.doi.org/10.3748/wjg.v28.i45.6356
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