Q: Since being diagnosed with Helicobacter pylori infection and chronic active gastritis (by esophagogastroduodenoscopy) in 2006, a 58-year-old man has undergone three different treatment regimens. Each time, however, his H. pylori stool antigen remained positive at testing one to two months after treatment ended. Recently a gastroenterologist recommended a combination of amoxicillin 500 mg b.i.d. (used in all three previous regimens) + rifabutin 150 mg b.i.d. + pantoprazole (Protonix) 40 mg b.i.d. for 14 days. Your comment, please.

A: Recent reports have noted good success in treating resistant H. pylori infection with a new regimen of rifabutin 150 or 300 mg b.i.d. and amoxicillin 1 g b.i.d. for 10 days. However, this patient has already had amoxicillin, so this regimen is not optimal. American College of Gastroenterology