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Rifaximin-based regimens for eradication of Helicobacter pylori: a pilot study.

Author(s): Gasbarrini A, Lauritano EC, Nista EC, Candelli M, Gabrielli M, Santoro M, Zocco MA, Cazzato A, Finizio R, Ojetti V, Cammarota G, Gasbarrini G

Affiliation(s): Department of Internal Medicine, Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy. agasbarrini@rm.unicatt.it

Publication date & source: 2006, Dig Dis., 24(1-2):195-200.

Publication type: Randomized Controlled Trial

BACKGROUND: Triple therapy is the treatment of choice for Helicobacter pylori-infected patients with an eradication rate ranging from 70 to 85%. Poor compliance and antibiotic resistance are the main causes of treatment failure. The aim of the present study was to assess the efficacy of rifaximin, a poorly absorbed antibiotic, for H. pylori eradication. METHODS: We enrolled 48 consecutive H. pylori-positive patients affected. They were randomized to receive two 7-day rifaximin-based triple therapies: rifaximin tablets 400 mg t.i.d., esomeprazole 40 mg o.d. and clarithromycin 500 mg b.i.d. (CRE) or levofloxacin 500 mg o.d. (LRE). H. pylori eradication was assessed using a (13)C-urea breath test 4 weeks after the end of therapy. Treatment compliance and the incidence of side effects were also evaluated. RESULTS: No dropouts were observed. The eradication rate both on intention-to-treat and per-protocol analysis did not show significant differences between groups: 58% (14/24 patients) in group 1 and 42% (10/24 patients) in group 2 (p = 0.24, OR 1.96, 95% CI 0.62-6.18). No significant differences in patients' compliance and incidence of side effects were found between groups. CONCLUSIONS: Rifaximin-based therapy showed optimal compliance but a limited eradication rate compared to standard first-line treatment. Further investigations are needed to evaluate different dosages and combinations. Copyright 2006 S. Karger AG, Basel.

Page last updated: 2006-11-04

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