Randomized Study On Two "Rescue" Therapies For H-Pylori Infected Patients After Failure Of Standard "Triple Therapy" Regimens.

Background & Aim: A novel rifabutin-based therapy is able to cure H.pylori infection in 79% of patients who failed eradication after standard PPI-based triple therapy.We compared this new regimen with the quadruple therapy in a randomized prospective single-center study performed on patients with at least one prevously failed course of PPI-based standard triple therapy.Methods: One hundred-thirty-five patients were randomized into three groups who were treated for 10 days with pantoprazole 40mg bid, amoxycillin Ig bid, and rifabutin 150mg od (group A) or 300mg od (group B), and pantoprazole 40mg bid, metronidazole 250mg tid, bismuth citrate 240mg bid, and tetracycline 500mg qid (group C).Before starting therapy, patients underwent endoscopy with biopsies for histology, culture, and antibiotic susceptibility tests.H.pylori eradication was assessed by 13C-urea breath test (UBT).Patients were considered compliant if they took 2' 80% of assigned treatment.Side effects were recorded by clinical interview.Results: All patients were found to be H.pylori infected on both