The in vitro sensitivity- of Helicobacter pylori to rifaximin, a new rifamycin antibiotic, was evaluated in 40 clinical isolates by the agar dilution method. Rifaximin showed good activity, with a 50% minimum inhibitory concentration of 4 mg/L-1. Consequently, we assessed rifaximin in H pylori-positive patients. Overall, 71 patients with upper gastrointestinal symptoms (35 men and 36 women; aged 19 to 73 years, mean, 45.6 years) were found to have H pylori-associated gastritis. The first 30 consecutive patients received monotherapy with rifaximin 600 mg three times a day (TID) for 14 days. The 41 patients enrolled thereafter were allocated in an open, randomized fashion to four different-treatment groups for 14 days: (1) rifaximin 600 mg TID and colloidal bismuth subcitrate 240 mg twice a day (BID) (n = 10); (2) rifaximin 600 mg TID and omeprazole 20 mg BID (n = 10); (3) rifaximin 600 mg TID and amoxicillin 1 g BID (n = 10); or (4) rifaximin 1800 mg TID and metronidazole 500 mg TID (n = 11). Upper gastrointestinal symptoms (pyrosis, bloating, epigastric pain, and nausea) were recorded and assessed before and 4 weeks after treatment. Patients were assessed by endoscopy, histology, CP test, culture, and serology (immunoglobulin G [IgG] to H pylori) at entry. Sixty-seven patients were available for follow-up 4 weeks after the completion of treatment. A statistically significant improvement in symptoms was seen in patients treated with rifaximin and rifaximin plus colloidal bismuth subcitrate. No statistically significant-differences in degree of improvement in endoscopic and histologic findings were seen among the five treatment groups. A statistically significant decrease in the mean IgG value after treatment was found for rifaximin, rifaximin plus colloidal bismuth subcitrate, and rifaximin plus omeprazole. The overall eradication rate was 43%. These results suggest that rifaximin may be an effective antibiotic againstr pylori infection and is worthy of further study.
Rifaximin suspension for the eradication of helicobacter pylori
Vaira D.;Biasco G.;Ricci C.;Milesi F.;Barbara L.
1997
Abstract
The in vitro sensitivity- of Helicobacter pylori to rifaximin, a new rifamycin antibiotic, was evaluated in 40 clinical isolates by the agar dilution method. Rifaximin showed good activity, with a 50% minimum inhibitory concentration of 4 mg/L-1. Consequently, we assessed rifaximin in H pylori-positive patients. Overall, 71 patients with upper gastrointestinal symptoms (35 men and 36 women; aged 19 to 73 years, mean, 45.6 years) were found to have H pylori-associated gastritis. The first 30 consecutive patients received monotherapy with rifaximin 600 mg three times a day (TID) for 14 days. The 41 patients enrolled thereafter were allocated in an open, randomized fashion to four different-treatment groups for 14 days: (1) rifaximin 600 mg TID and colloidal bismuth subcitrate 240 mg twice a day (BID) (n = 10); (2) rifaximin 600 mg TID and omeprazole 20 mg BID (n = 10); (3) rifaximin 600 mg TID and amoxicillin 1 g BID (n = 10); or (4) rifaximin 1800 mg TID and metronidazole 500 mg TID (n = 11). Upper gastrointestinal symptoms (pyrosis, bloating, epigastric pain, and nausea) were recorded and assessed before and 4 weeks after treatment. Patients were assessed by endoscopy, histology, CP test, culture, and serology (immunoglobulin G [IgG] to H pylori) at entry. Sixty-seven patients were available for follow-up 4 weeks after the completion of treatment. A statistically significant improvement in symptoms was seen in patients treated with rifaximin and rifaximin plus colloidal bismuth subcitrate. No statistically significant-differences in degree of improvement in endoscopic and histologic findings were seen among the five treatment groups. A statistically significant decrease in the mean IgG value after treatment was found for rifaximin, rifaximin plus colloidal bismuth subcitrate, and rifaximin plus omeprazole. The overall eradication rate was 43%. These results suggest that rifaximin may be an effective antibiotic againstr pylori infection and is worthy of further study.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
