Affiliation:
1. Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases; Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
2. Department of Gastroenterology, Shanghai Songjiang District Central Hospital , Shanghai , China
3. Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University school of Medicine , Hangzhou , China
Abstract
Abstract
Background
We compared the efficacy and safety of rifabutin-containing triple therapy with bismuth quadruple therapy for rescue treatment of Helicobacter pylori.
Methods
This was a noninferiority study trial of H. pylori treatment for subjects who had failed at least 2 prior treatments. Subjects were randomly assigned to receive rifabutin triple therapy with 14-day esomeprazole (20 mg), amoxicillin (1.0 g), and rifabutin (150 mg) twice a day; or bismuth quadruple therapy with esomeprazole (20 mg) and bismuth (220 mg) twice a day, plus metronidazole (400 mg) and tetracycline (500 mg) 4 times a day. Antimicrobial susceptibility was assessed by agar dilution and E-test.
Results
From May 2021 to October 2022, a total of 364 subjects were randomized. The eradication rates by intention-to-treat, per-protocol, and modified intention-to-treat were 89.0% (162/182; 95% confidence interval [CI], 83.6%–92.8%), 94.0% (157/167; 95% CI, 89.3%–96.7%), and 93.6% (162/173; 95% CI, 89.0%–96.4%) for rifabutin triple group. For bismuth quadruple group, they were 89.6% (163/182; 95% CI, 84.3%–93.2%), 95.3% (143/150; 95% CI, 90.7%–97.7%), and 93.7% (163/174; 95% CI, 89.0%–96.4%).
Conclusions
The rifabutin triple therapy is an alternative to classical bismuth quadruple therapy for the rescue treatment of H. pylori with fewer side effects and higher compliance.
Clinical Trials Registration
NCT04879992.
Funder
National Natural Science Foundation of China
Shanghai Jiaotong University
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Immunology and Allergy
Cited by
2 articles.
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