Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Olga P. Nyssen, Dino Vaira, Ilaria Maria Saracino, Giulia Fiorini, María Caldas, Luis Bujanda, Rinaldo Pellicano, Alma Keco-Huerga, Manuel Pabón-Carrasco, Elida Oblitas Susanibar, Alfredo Di Leo, Giuseppe Losurdo, Ángeles Pérez-Aísa, Antonio Gasbarrini, Doron Boltin, Sinead Smith, Perminder Phull, Theodore Rokkas, Dominique Lamarque, Anna Cano-CatalàIgnasi Puig, Francis Mégraud, Colm O’morain, Javier P. Gisbert*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background: First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. METHODS: International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Results: Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukope-nia and thrombocytopenia with fever requiring hospitalisation. Conclusion: Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.

Original languageEnglish
Article number1658
JournalJournal of Clinical Medicine
Issue number6
Publication statusPublished - 16 Mar 2022


  • Bismuth
  • Culture
  • Eradication failure
  • H. pylori
  • Helicobacter pylori
  • Hp-EuReg
  • Rescue
  • Rifabutin
  • Treatment


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