Efficacy of Rifabutin-Based Helicobacter pylori Eradication Regimen in Korea With High Prevalence of Tuberculosis Infection

Background As the antibiotic resistance and treatment failure rates of Helicobacter pylori are rising, the need for rescue therapy with rifabutin for H. pylori eradication (HPE) is also increasing. Therefore, in this study, we investigated the efficacy, resistance status, and adverse events in patients receiving rifabutin-based HPE. Materials and methods Between January 2020 and December 2022, 3006 patients underwent esophagogastroduodenoscopy (EGD) with H. pylori culture tests. Of these, culture results were successfully obtained from 1792 patients, who were subsequently enrolled in our study. The medical records of these patients were retrospectively reviewed, and their clinical features and outcomes assessed. Results Among the 1792 patients, 14 (0.8%) were rifabutin-resistant. A total of 665 (37.1%) patients had multidrug-resistant (MDR) H. pylori infections. Patients with rifabutin-resistant H. pylori infections had a significantly higher rate of tuberculosis treatment history (2.8% vs. 28.6%, p Conclusions The rifabutin-based HPE regimen could be an effective and safe treatment method. It is particularly considered a viable therapeutic option for patients who require HPE but have previously failed to respond to multiple HPEs.