González Carro Pedro, Pérez Roldán Francisco, De Pedro Esteban Aurora, Legaz Huidobro Maria L, Soto Fernández Susana, Roncero Garcia Escribano Oscar, Esteban López-Jamar Jose M, Pedraza Martin Carmen, Ruíz Carrillo Francisco
Digestive Unit, Hospital General Mancha-Centro, Alcázar de San Juan, Spain.
J Gastroenterol Hepatol. 2007 Jan;22(1):60-3. doi: 10.1111/j.1440-1746.2006.04375.x.
Even with the current most effective treatment regimens for Helicobacter pylori infection, a considerable number of patients will be resistant to eradication. The aim of the present study was to evaluate the H. pylori eradication rate in patients resistant to standard therapies when treated with a triple therapy of pantoprazole, rifabutin and amoxicillin.
Ninety-two consecutive patients diagnosed with H. pylori infection resistant to two previous treatment regimens were treated with pantoprazole, rifabutin and amoxicillin for 10 days. The persistence or eradication of H. pylori was determined by a 13C-urea breath test performed 4 weeks after the treatment.
Per protocol eradication was achieved in 62.2% of patients and the intention-to-treat eradication was 60.8%. Only two patients were excluded for adverse events related to the treatment.
The eradication rate is acceptable as a third-line therapy, particularly in centers with high cure rate for first line therapy. Another important value of this study is the good tolerance for the treatment observed in our patients. It is possible that rifabutin-based triple therapy may be of use in hospital centers that do not have disposable culture and susceptibility methods against H. pylori.
即便采用目前针对幽门螺杆菌感染最有效的治疗方案，仍有相当数量的患者会出现根除治疗抵抗。本研究旨在评估对标准疗法耐药的患者接受泮托拉唑、利福布汀和阿莫西林三联疗法治疗时的幽门螺杆菌根除率。
92例连续入选的被诊断为对之前两种治疗方案耐药的幽门螺杆菌感染患者，接受泮托拉唑、利福布汀和阿莫西林治疗10天。治疗4周后通过13C-尿素呼气试验确定幽门螺杆菌的持续存在或根除情况。
按方案分析，62.2%的患者实现了根除，意向性分析的根除率为60.8%。仅2例患者因与治疗相关的不良事件被排除。
作为三线治疗，根除率是可接受的，尤其是在一线治疗治愈率高的中心。本研究的另一个重要价值在于观察到患者对该治疗具有良好的耐受性。基于利福布汀的三联疗法可能适用于没有针对幽门螺杆菌的一次性培养和药敏检测方法的医院中心。
