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Helicobacter pylori
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Rifabutin therapies Rifabutin (150 mg once or twice daily), amoxicillin (1.5 g), and esomeprazole 40 mg (or an equivalent PPI) every 8 h for 14 days.Rifabutin 150 mg, amoxicillin 1 g, bismuth subcitrate or subsalicylate two tablets, a PPI all twice daily for 14 days.
Rifabutin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
H. pylori is usually susceptible to rifabutin (MIC 0.004–0.016 µg/ml) (Heep et al., 1999; Glocker et al., 2007). The prevalence of resistance remains low: 0.6% in treatment-naive patients to 1.59% in post-treatment patients in a meta-analysis (n = > 1000 isolates) (Gisbert et al., 2012). When combined with other antimicrobials, rifabutin is bactericidal, even in strains resistant to other antimicrobials (Jodlowski et al., 2008).
Combined hormonal contraception
Published in John Guillebaud, Contraception Today, 2016
It has been shown that 4 or more weeks may elapse before excretory function in the liver reverts to normal. Hence, if any of these drugs has been used for more than 1 month (or at all in the case of rifampicin or rifabutin), there should be a delay of about 4 weeks before returning to a standard low-dose CHC regimen. This period should be increased to 8 weeks after more prolonged use of enzyme inducers. In all cases, there should be no PFI gap between the higher-dose and low-dose packets.
Evaluating treatments with rifabutin and amoxicillin for eradication of Helicobacter pylori infection in adults: a systematic review
Published in Expert Opinion on Pharmacotherapy, 2022
Elias Xirouchakis, Sotirios D. Georgopoulos
All the above regimens were not influenced by clarithromycin and metronidazole single or dual resistances. In addition, the choice of PPI did not affect outcome [62]. In the study by Miehlke et al, the CYP2C19 status, which influences the metabolic activity to PPIs, was assessed and found that extensive metabolizers (homozygotes) had lower eradication rates (75%) compared to intermediate (heterozygotes) and poor metabolizers (84%) [59]. This was probably overcome by treatments using high PPI doses [83]. However, it is also known that amoxicillin is enhancing the antimicrobial activity of rifabutin. Therefore, there were three optimized regimens that increased dose and/or frequency of the PPI and/or amoxicillin. In the first of a 7-day duration, the dose of amoxicillin increased to 1gr three times daily [70], in the second of 10 or 12 day duration, the dose of PPI was doubled [69,74,79,80], and in the third, the highly optimized choice, both PPI dosing increased to double dose twice daily or standard dose four times daily and amoxicillin to three or four times daily [58,72,82,83] for a duration of 12 to 14 days reaching eradication rates of 78% (25/32 patients), 71.1% (478/672 patients) and 85.4% (359/420 patients), respectively. Finally, in a recent study with 19 patients, the newly introduced potent acid-inhibitor Vonoprazan achieved a 100% eradication rate [81].
Antiretroviral treatment for HIV infection: Swedish recommendations 2019
Published in Infectious Diseases, 2020
Jaran Eriksen, Christina Carlander, Jan Albert, Leo Flamholc, Magnus Gisslén, Lars Navér, Veronica Svedhem, Aylin Yilmaz, Anders Sönnerborg
Recommendations for co-treatment of HIV and tuberculosis:efavirenz regular dose (600 mg × 1) + two NRTIs and isoniazid, rifampicin, ethambutol and pyrazinamide in regular dosesordolutegravir regular dose + two NRTI and tuberculostatics as above, with the difference that rifabutin dosed 300 mg daily replaces rifampicin. An alternative is to give dolutegravir 50 mg × 2 with isoniazid, rifampicin, ethambutol, and pyrazinamide in regular dosesorThe combination of PI/r and rifampicin is contraindicated. Instead, use PI/r in normal dosage + two NRTIs with rifabutin, isoniazid, ethambutol and pyrazinamide. The optimal dose of rifabutin with PI/r is not clear and may vary with different PIs. For the most commonly used PI, darunavir/r, there are limited data indicating that rifabutin 150 mg/day is the most appropriate dose [100]. Follow-up monitoring of the drug concentration of rifabutin is recommended. Be aware of side effects such as neutropenia and uveitis.
Repositioning rifamycins for Mycobacterium abscessus lung disease
Published in Expert Opinion on Drug Discovery, 2019
Uday S. Ganapathy, Véronique Dartois, Thomas Dick
As a derivative of the naturally occurring rifamycin B, the structure of rifampicin features a napthoquinone ring bridged by an aliphatic ansa chain. The hydroquinone of this ring (i.e., hydroxyl groups at C1 and C4 positions) is susceptible to autoxidation in the presence of oxygen and divalent metal cations as a catalyst, generating rifampicin quinone (Figure 1) [77]. Consistent with this, autoxidation of rifampicin results in a loss of anti-mycobacterial activity [78]. Similar results are observed with rifapentine, a rifamycin with the same hydroquinone structure and no activity against M. abscessus [64,78]. Rifabutin, however, does not have a susceptible hydroquinone (Figure 1). As a result, rifabutin is resistant to autoxidation and does not lose potency under oxidizing conditions [78].