Rifabutin-containing therapy depicts a safe and efficacious approach following one or even more failures of H. pylori elimination treatment.

This study was carried out to investigate safety and effectiveness of rifabutin-containing regimens for Helicobacter pylori (H. pylori) eradication.

In this sub-analysis of European Registry on H. pylori Management (Hp-EuReg), rifabutin-treated people were registered. Per-protocol and modified intention-to-treat evaluations were conducted. The study data were subjected to quality control. H. pylori eradication rate achieved was the major outcome ascertained.

In total, 500 volunteers (mean age 52 years, 4% with peptic ulcer, and 63% with dyspepsia) incorporated in Hp-EuReg received rifabutin therapy. In 63% of cases, the culture was conducted. Triple resistance (to levofloxacin, metronidazole, clarithromycin,) was witnessed in 39% of cases, and dual resistance (to both metronidazole and clarithromycin) was witnessed in 46% of cases.

Rifabutin was utilized as a part of triple therapy along with proton-pump-inhibitor and amoxicillin in about 87% of cases. The addition of bismuth to the triple regimen was done in an additional 6% of participants. Rifabutin therapy was majorly utilized in fourth-line (27%), third-line (25%), and second-line (32%) regimens, attaining 66%, 80%, and 78% overall efficacy by modified intention-to-treat, respectively.

The compliance with treatment was found to be 89%. In 26% of the participants (most commonly nausea), at least 1 adverse effect was noted. Notably, 1 severe adverse effect (0.2%) was witnessed in 1 subject with leukopenia and thrombocytopenia with fever needing hospitalization.

Rifabutin-containing therapy appears to be beneficial for the management of H. pylori-infected people.