Gut Liver.  2012 Oct;6(4):452-456.

Rifaximin Plus Levofloxacin-Based Rescue Regimen for the Eradication of Helicobacter pylori

• Yun SP
• Seon HG
• Ok CS
• Yoo KH
• Kang MK
• Kim WH
• Kwon CI
• Ko KH
• Hwang SG
• Park PW
• Hong SP

Abstract

BACKGROUND/AIMS
This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori.
METHODS
We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week.
RESULTS
In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively.
CONCLUSIONS
A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.

Keyword

Helicobacter pylori; Eradication; Rifaximin

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles
Amoxicillin
Bismuth
Clarithromycin
Helicobacter
Helicobacter pylori
Humans
Metronidazole
Ofloxacin
Rifamycins
Tetracycline
2-Pyridinylmethylsulfinylbenzimidazoles
Amoxicillin
Bismuth
Clarithromycin
Metronidazole
Ofloxacin
Rifamycins
Tetracycline