Nyssen, Olga PVaira, DinoSaracino, Ilaria MariaFiorini, GiuliaCaldas, MaríaBujanda, LuisPellicano, RinaldoKeco-Huerga, AlmaPabon-Carrasco, ManuelOblitas Susanibar, ElidaDi Leo, AlfredoLosurdo, GiuseppePérez-Aísa, ÁngelesGasbarrini, AntonioBoltin, DoronSmith, SineadPhull, PerminderRokkas, TheodoreLamarque, DominiqueCano-Català, AnnaPuig, IgnasiMégraud, FrancisO'Morain, ColmGisbert, Javier P2023-05-032023-05-032022-03-162077-0383http://hdl.handle.net/10668/21257First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukopenia and thrombocytopenia with fever requiring hospitalisation. Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/H. pyloriHelicobacter pyloriHp-EuRegbismuthcultureeradication failurerescuerifabutintreatmentHelicobacter pyloriRifabutinAnti-Bacterial AgentsProton Pump InhibitorsDrug Resistance, Bacterialresearch article35329984open accessHelicobacter pyloriRifabutinaTerapia de ErradicaciónInhibidores de la Bomba de ProtonesResistencia Antimicrobiana10.3390/jcm11061658PMC8949410https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949410/pdf