A novel rifabutin-based treatment (RHB-105) for Helicobacter pylori infection has been examined in a double-blind, randomised, controlled trial in the United States. The study involved 455 patients with epigastric discomfort and confirmed H pylori infection, who received either RHB-105 (consisting of amoxicillin 3g, omeprazole 120mg and rifabutin 150mg) or an active comparator (amoxicillin 3g and omeprazole 120mg) every 8 hours for 14 days. The 13C urea breath test was conducted four weeks following treatment. H pylori eradication rates were higher in patients given RHB-105 than in those given the active comparator (83.8% [95% CI, 78.4% to 88.0%] vs. 57.7% [95% CI, 51.2% to 64.0%]; P < 0.001). Clarithromycin or metronidazole resistance did not affect eradication rates, while no rifabutin resistance was identified. Common adverse events included diarrhoea, headache and nausea. These results are significant as they demonstrate the efficacy of RHB-105 in eradicating H pylori in an environment where eradication rates of most therapies are reduced due to increasing antibiotic resistance.The original research, published in the Annals of Internal Medicine, can be viewed here.

Contributed by Australian Medication Safety Services Associate – Isabella Singh