One-week once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin for eradication of persistent Helicobacter pylori resistant to both metronidazole and clarithromycin
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One-week once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin for eradication of persistent Helicobacter pylori resistant to both metronidazole and clarithromycin. / Miehlke, Stephan; Schneider-Brachert, Wulf; Kirsch, Christian; Morgner, Andrea; Madisch, Ahmed; Kuhlisch, Eberhard; Haferland, Christian; Bästlein, Elke; Jebens, Claus; Zekorn, Christian; Knoth, Holger; Stolte, Manfred; Lehn, Norbert.
In: HELICOBACTER, Vol. 13, No. 1, 02.2008, p. 69-74.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - One-week once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin for eradication of persistent Helicobacter pylori resistant to both metronidazole and clarithromycin
AU - Miehlke, Stephan
AU - Schneider-Brachert, Wulf
AU - Kirsch, Christian
AU - Morgner, Andrea
AU - Madisch, Ahmed
AU - Kuhlisch, Eberhard
AU - Haferland, Christian
AU - Bästlein, Elke
AU - Jebens, Claus
AU - Zekorn, Christian
AU - Knoth, Holger
AU - Stolte, Manfred
AU - Lehn, Norbert
PY - 2008/2
Y1 - 2008/2
N2 - AIM: To investigate a 1-week once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin for rescue therapy of Helicobacter pylori infection.METHODS: Consecutive patients (n = 103) with at least one previous treatment failure and H. pylori infection resistant to both metronidazole and clarithromycin were treated with esomeprazole 40 mg, moxifloxacin 400 mg, and rifabutin 300 mg, given once daily for 7 days. Eradication was confirmed by histology and culture. CYP2C19 status was determined by polymerase chain reaction-restriction fragment length polymorphism.RESULTS: Intention-to-treat and per-protocol eradication rates were 77.7% (68.4-85.3) and 83.3% (74.4-90.2). Five patients discontinued prematurely (4.8%). Eradication was achieved in 93.1% of poor/intermediate metabolizers and in 78.8% of homozygous extensive metabolizers (p = .14). Eradication rates in patients with one, two, three, and four or more previous failures were 78.3%, 89.6%, 68.6%, and 88.9%, respectively (p = .21). The regimen was effective in seven of nine patients who previously failed quadruple therapy. Post-treatment resistance to moxifloxacin and rifabutin was detected in two (12.5%) and five (31%) patients after treatment failure.CONCLUSION: Once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin is a promising, safe, and convenient regimen for rescue therapy of H. pylori infection that may serve as a valuable alternative to quadruple therapy, particularly for patients with intolerance to amoxicillin.
AB - AIM: To investigate a 1-week once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin for rescue therapy of Helicobacter pylori infection.METHODS: Consecutive patients (n = 103) with at least one previous treatment failure and H. pylori infection resistant to both metronidazole and clarithromycin were treated with esomeprazole 40 mg, moxifloxacin 400 mg, and rifabutin 300 mg, given once daily for 7 days. Eradication was confirmed by histology and culture. CYP2C19 status was determined by polymerase chain reaction-restriction fragment length polymorphism.RESULTS: Intention-to-treat and per-protocol eradication rates were 77.7% (68.4-85.3) and 83.3% (74.4-90.2). Five patients discontinued prematurely (4.8%). Eradication was achieved in 93.1% of poor/intermediate metabolizers and in 78.8% of homozygous extensive metabolizers (p = .14). Eradication rates in patients with one, two, three, and four or more previous failures were 78.3%, 89.6%, 68.6%, and 88.9%, respectively (p = .21). The regimen was effective in seven of nine patients who previously failed quadruple therapy. Post-treatment resistance to moxifloxacin and rifabutin was detected in two (12.5%) and five (31%) patients after treatment failure.CONCLUSION: Once-daily triple therapy with esomeprazole, moxifloxacin, and rifabutin is a promising, safe, and convenient regimen for rescue therapy of H. pylori infection that may serve as a valuable alternative to quadruple therapy, particularly for patients with intolerance to amoxicillin.
KW - Adult
KW - Aged
KW - Anti-Bacterial Agents
KW - Aryl Hydrocarbon Hydroxylases
KW - Aza Compounds
KW - Clarithromycin
KW - Cytochrome P-450 CYP2C19
KW - Drug Resistance, Bacterial
KW - Drug Therapy, Combination
KW - Esomeprazole
KW - Female
KW - Fluoroquinolones
KW - Gastric Mucosa
KW - Helicobacter Infections
KW - Helicobacter pylori
KW - Humans
KW - Male
KW - Metronidazole
KW - Middle Aged
KW - Mixed Function Oxygenases
KW - Polymorphism, Restriction Fragment Length
KW - Prospective Studies
KW - Quinolines
KW - Rifabutin
KW - Clinical Trial
KW - Journal Article
KW - Multicenter Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1111/j.1523-5378.2007.00588.x
DO - 10.1111/j.1523-5378.2007.00588.x
M3 - SCORING: Journal article
C2 - 18205669
VL - 13
SP - 69
EP - 74
JO - HELICOBACTER
JF - HELICOBACTER
SN - 1083-4389
IS - 1
ER -