Mycobutin (rifabutin) / Pfizer, Lupin - LARVOL DELTA

Development, Validation, and Clinical Application of a Simultaneous Quantification Method of Seventeen Antituberculosis Drugs in Plasma, Serum, or Saliva Using LC-MS/MS. (PubMed, Ther Drug Monit) - "This validated LC-MS/MS method allows simultaneous analysis of multiple anti-TB drugs in plasma, serum, and saliva, facilitating clinical and research applications. The method has been successfully applied in clinical practice."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Pulmonary Penetration of Intravenous Rifabutin in Healthy Participants: A Multiple-Dose Pharmacokinetic Study. (PubMed, Int J Antimicrob Agents) - "Intravenous rifabutin achieves pulmonary exposures substantially exceeding plasma concentrations, providing a strong pharmacological rationale for further clinical evaluation of BV100 in severe CRAB pneumonia."

Journal • PK/PD data • Infectious Disease • Pneumonia • Respiratory Diseases

Drug resistance in extrapulmonary tuberculosis in South Korea, 2010–2019: a comparison with pulmonary tuberculosis (ERS 2026) - "Among the 706 new patients with EPTB, the resistance rates to isoniazid (INH) and rifampicin (RIF) were 8.5% and 2.4%, respectively; the proportions of RIF-susceptible, INH-resistant TB (Hr-TB), multidrug/rifampicin-resistant TB (MDR/RR-TB), and pre-extensively drug-resistant TB were 6.7%, 2.4%, and 0.7%, respectively. When comparing new patients in the EPTB group with those in the PTB group (8,607 patients), the resistance rates to RIF, ethambutol, and rifabutin, and proportion of MDR/RR-TB were significantly lower in the EPTB group... This study provides important information on the resistance status and trends among patients with EPTB in South Korea. To improve the management of patients with EPTB, efforts to identify drug resistance as well as regular updates to the DST database are essential."

Infectious Disease • Respiratory Diseases • Tuberculosis

SUCCESSFUL TREATMENT OF MILIARY TUBERCULOSIS WITH RIFABUTIN-BASED THERAPY IN A PATIENT WITH SEVERE HEPATIC AND RENAL DYSFUNCTION: A RIFAMPIN-SPARING STRATEGY (CHEST 2026) - No abstract available

Clinical • Infectious Disease • Nephrology • Renal Disease • Respiratory Diseases • Tuberculosis

In vitro activity of zosurabalpin against a global set of carbapenem-resistant-A. baumannii clinical isolates. (PubMed, Antimicrob Agents Chemother) - "We compared zosurabalpin's activity with currently available antibiotics, including colistin, cefiderocol, sulbactam-durlobactam, as well as rifabutin. Zosurabalpin MICs in CRAB isolates were generally low, including metallo-β-lactamase-producing-CRAB. The low MICs show a high potential to overcome current treatment limitations; however, mutations in lptD may contribute to resistance emergence and should be further studied."

Journal • Preclinical • Infectious Disease

Hot Tub Lung: Misdiagnosed Hypersensitivity Pneumonitis Revealing a Mycobacterial Aetiology-A Case Report and Literature Review. (PubMed, Respirol Case Rep) - "Following hot tub cessation and initiation of azithromycin, ethambutol and rifabutin, she ultimately achieved complete clinical and radiologic resolution. HTL represents a heterogeneous spectrum from immune-mediated hypersensitivity to true mycobacterial infection. Persistent interstitial lung disease despite ongoing immunosuppression should prompt a thorough hot tub exposure history and selected patients may require antimycobacterial therapy alongside exposure cessation."

Journal • Immunology • Infectious Disease • Inflammation • Interstitial Lung Disease • Nontuberculous Mycobacterial Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Molecular characterisation and mutational analysis of antimicrobial resistance genes in Helicobacter pylori isolates in Erbil, Iraq. (PubMed, Mutat Res) - "This study provides the first molecular surveillance data on antimicrobial resistance in Helicobacter pylori in northern Iraq, offering valuable regional evidence to guide local eradication strategies. The relatively high amoxicillin resistance, together with the elevated resistance to metronidazole, levofloxacin, and clarithromycin, underscores the need for susceptibility-guided therapy and continuous local antimicrobial resistance surveillance."

Biomarker • Journal • Dyspepsia • Infectious Disease

Salvia miltiorrhiza ultrafine powder improves ileal barrier function and health of hens during late laying period via TLR4/NF-κB-mediated macrophage polarization. (PubMed, Front Immunol) - "Dietary SMUP also modulated gut microbiota by reducing the Tenericutes abundance and enriching predicted ansamycin biosynthesis...Dietary SMUP improves intestinal health of late-laying hens by strengthening the intestinal barrier, alleviating inflammation (via inhibiting the TLR4/NF-κB pathway and promoting M2-type macrophage polarization), and modulating the gut microbiota. These improvements in intestinal health supported SMUP as a promising natural plant-derived feed additive for hens during late laying period."

Journal • Inflammation • CLDN1 • IFNG • IL10 • IL1B • IL4 • IL6 • NFKBIA • OCLN • RELA • TJP1 • TLR4 • TNFA

Synthetic Studies Toward Rubradirin. (PubMed, J Org Chem) - "For rubransarol, the ansamycin core fragment of rubradirin, synthetic protocols were established for the construction of the tricyclic core as well as the full-length ansa-chain. Finally, attachment of the ansa-chain was demonstrated at both anchor points of the rubransarol core, leading to the assembly of the 19-carbon skeleton of rubransarol."

Journal

Efficacy and Safety of Modern Salvage Therapies After Multiple Helicobacter pylori Eradication Failures: A Systematic Review and Meta-Analysis (ACG 2026) - "While several rescue strategies have emerged, including vonoprazan-amoxicillin dual therapy and rifabutin-based regimens. Of 1,605 identified records, 21 studies met the inclusion criteria. Twelve studies reported intention-to-treat (ITT) eradication outcomes involving 1,746 patients, while five studies reported modified intention-to-treat (mITT) outcomes involving 1,165 patients. ITT analysis demonstrated no significant difference in eradication rates between modern and conventional rescue regimens (OR 1.14, 95% CI 0.87â1.48; p=0.34; I²=63.1%)."

Retrospective data • Review • Infectious Disease

Efficacy and Safety of Rifabutin-Based Versus Bismuth-Containing Regimens in Helicobacter pylori Treatment: A Systematic Review and Meta-Analysis (ACG 2026) - "Six studies with 2,269 patients were analyzed. The pooled analysis showed no significant differences in eradication rates between rifabutin triple therapy and bismuth quadruple therapy (OR 0.59; p = 0.22), nor in the RCT sub-group (OR 0.97; p = 0.96). Safety outcomes showed no significant differences in abdominal pain (OR 0.35; p = 0.20) and dizziness (OR 0.33; p = 0.16), but rifabutin triple therapy had a significantly lower incidence of diarrhea (OR 0.49; p < 0.001), dyspepsia (OR 0.33; p < 0.001), and taste alteration (OR 0.32; p = 0.007)."

Retrospective data • Review • Dyspepsia • Gastric Cancer • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Peptic Ulcer • Solid Tumor

More Than a Lab Abnormality: Micronutrient Deficiency Preceding Neuroendocrine Tumors (ACG 2026) - "A 49-year-old woman with IDA, B12 deficiency, and bloating tested positive for H. pylori and was treated with omeprazole, amoxicillin, and rifabutin. The shared lesson is that unexplained or refractory nutritional deficiencies warrant a defined workup before being dismissed or treated empirically. The recognition of micronutrient deficiencies as a marker may help enable targeted surveillance and shift detection earlier."

Gastrointestinal Disorder • Gastrointestinal Neuroendocrine Tumor • Gynecological Neuroendocrine Tumor • Immunology • Neuroendocrine Tumor • Oncology • Solid Tumor • GAST

Simplified Vonoprazan Rescue Regimens for Persistent/Refractory Helicobacter pylori : A Rescue-Specific Meta-Analysis of Randomized Trials (ACG 2026) - "Additional prespecified comparisons were supported by only one eligible RCT each and were summarized without pooling: vonoprazan-amoxicillin had fewer adverse reactions than susceptibility-guided therapy (RR 0.29, 95% CI 0.16-0.54), adding Saccharomyces boulardii improved ITT eradication versus vonoprazan-amoxicillin alone (RR 1.16, 95% CI 1.03-1.30), and rifabutin-based vonoprazan triple therapy achieved comparable ITT eradication to quadruple therapy (RR 0.99, 95% CI 0.91-1.08). Six rescue-relevant RCTs were eligible; 3 RCTs (n=1,278) formed the main meta-analysis (vonoprazan-amoxicillin in 2 trials; vonoprazan-tetracycline in 1 trial). Dual therapy did not show a clear intention-to-treat (ITT) eradication advantage versus quadruple therapy (RR 0.94, 95% CI 0.85-1.05; I²=74.3%). Modified ITT (RR 0.93, 95% CI 0.84-1.04; I²=82.2%) and per-protocol analyses (RR 0.93, 95% CI 0.85-1.02; I²=76.3%) were concordant."

Retrospective data • Infectious Disease

Rifabutin Induced Febrile Neutropenia in Salvage Therapy for Refractory H. pylori Infection (ACG 2026) - "Case Description/ A 32âyearâold woman with recurrent dyspepsia, reflux, and bloating was found to have persistent H. pylori infection despite multiple eradication attempts, including clarithromycinâbased triple therapy, metronidazoleâbased therapy, and tetracyclineâ and levofloxacinâcontaining regimens...She was started on salvage therapy with rifabutin, doxycycline, bismuth, and pantoprazole...This case highlights the importance of baseline and interval CBC monitoring when prescribing rifabutinâcontaining salvage regimens for refractory H. pylori. Early recognition and prompt discontinuation typically result in rapid hematologic recovery."

Dyspepsia • Febrile Neutropenia • Hematological Disorders • Infectious Disease • Leukopenia • Neutropenia

GI Bleeding in a Solid Organ Transplant Recipient (SOTR) from Disseminated Mycobacterium avium Complex (MAC) with Gastrointestinal Involvement: A Case Report (ACG 2026) - "He was treated with azithromycin, ethambutol, and rifabutin. Figure: Figure 1: Second and third portion of the duodenum characterized by coarsely granular and nodular appearance with diffuse congestion and friability. Figure: Figure 2A: H&E Stain: Duodenal mucosa with loss of villi and expansion of the lamina propria by foamy histiocytes (100x view) Figure 2B: Acid-Fast Stain: Lamina propria histiocytes containing numerous intracellular acid-fast bacilli, consistent with mycobacteria (200x view)"

Case report • Clinical • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Solid Organ Transplantation • Transplantation • IFNG

Vonoprazan-Based Rescue Regimens Versus Bismuth Quadruple Therapy for Refractory Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (ACG 2026) - "Three randomized controlled trials comprising 1,278 patients were included. Vonoprazan-based rescue regimens included vonoprazan-amoxicillin dual therapy, vonoprazan-tetracycline dual therapy, and vonoprazan-rifabutin-amoxicillin triple therapy, while comparator arms received BQT rescue regimens. For the primary outcome of ITT eradication, vonoprazan-based therapy demonstrated efficacy comparable to BQT (OR 0.94, 95% CI 0.71-1.25; p=0.662)."

Retrospective data • Review • Infectious Disease

Isoniazid-Induced Hepatotoxicity in a NAT2 Slow Acetylator With Autoimmune-Like Serologies (ACG 2026) - "Sequential introduction of rifabutin, ethambutol, PZA, and moxifloxacin were well tolerated without recurrent hepatotoxicity. Marked hepatocellular injury with rapid resolution after drug withdrawal supports INH-DILI which may mimic autoimmune hepatitis. NAT2 genotyping helped identify INH as the likely culprit and guided avoidance of rechallenge amid multiple potentially hepatotoxic TB agents while alternative therapies were safely introduced."

Autoimmune Hepatitis • Eosinophilia • Hepatology • Immunology • Infectious Disease • Inflammation • Influenza • Liver Failure • Musculoskeletal Pain • Novel Coronavirus Disease • Respiratory Diseases • Tuberculosis • NAT2

H. pylori : Why Treatment Fails (and What to Do Next) (ACG 2026) - "Clarithromycin-based triple therapy (CTT), once >90% effective, now underperforms and complicates post-treatment confirmation when proton pump inhibitors (PPIs) reduce urea breath test (UBT) sensitivity...In refractory disease, reported salvage eradication was 83.3%â89.5% for vonoprazan-based regimens, 81.3%â89.2% for high-dose dual therapy, and 80.7%â100% for rifabutin-based triple therapy... In the real-world cohort, overall treatment failure was 18%; failure was 16.3% with CTT and 29.2% with bismuth quadruple therapy (p=0.13). Across comparative studies, CTT eradication ranged from 61.9% to 88.8%. In RCT meta-analysis, mBQT achieved higher pooled intention-to-treat eradication than CTT (84.8% vs 74.1%; OR 2.02, 95% CI 1.61â2.55; p< 0.00001), with some sequential and high-dose regimens exceeding 90%."

Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Peptic Ulcer

When the Cure Becomes the Risk: A Case of Rifaximin-Induced Neutropenia (ACG 2026) - "Lactulose remains first-line therapy, with rifaximin-a nonabsorbable rifamycin derivative-commonly used for prevention of recurrent episodes... Leukopenia and neutropenia have been reported with other rifamycin derivatives, including rifampin and rifabutin...In contrast, this case is notable fro delayed onset after prolonged exposure, with no alternative infectious, nutritional, or marrow-intrinsic etiology identified. This case highlights a rare but potentially serious adverse event associated with rifaximin use and underscores the importance of maintaining clinical vigilance for hematologic abnormalities in patients receiving long-term therapy."

Clinical • Cardiovascular • CNS Disorders • Endocrine Disorders • Fibrosis • Gastroenterology • Hepatic Encephalopathy • Hepatology • Hypertension • Immunology • Leukopenia • Liver Cirrhosis • Neutropenia

First Reported Human Case of Helicobacter Felistomachi Gastritis Refractory to Standard and Salvage Eradication Therapy (ACG 2026) - "Completion of bismuth quadruple therapy with tetracycline was complicated by Clostridioides difficile colitis and treated with vancomycin...After a course of salvage rifabutin triple therapy, repeat biopsies revealed persistent chronic active non-pylori Helicobacter gastritis, and confirmatory sequencing identified Helicobacter felistomachi...Throughout this course, his concurrent uncontrolled ulcerative colitis required a prednisone taper and vedolizumab induction...Figure: Figure 2: IHC 100x Helicobacter immunohistochemical stain (100x) highlighting the elongated spiral morphology of Helicobacter felistomachi organisms within gastric glands. Species identification confirmed by 16S rRNA polymerase chain reaction sequencing."

Clinical • Dyspepsia • Extranodal Marginal Zone Lymphoma • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Inflammatory Bowel Disease • Lymphoma • Marginal Zone Lymphoma • Peptic Ulcer • Ulcerative Colitis

Party of Three: Gastric MALT Lymphoma, Persistent Helicobacter pylori and a t(11;18) Translocation (ACG 2026) - "Case Description/ A 60-year-old man with ulcerative proctosigmoiditis on mesalamine presented with dyspepsia, unintentional weight loss with positive stool H. pylori antigen (Ag) which was treated with triple therapy (clarithromycin, amoxicillin, and omeprazole)...Treatment with Rifabutin salvage therapy and targeted radiation therapy were initiated...Instead, these patients require involved-site radiation therapy (ISRT), use of anti-CD20 monoclonal AB, rituximab, or rituximab with chemotherapy with surveillance EGD with mapping biopsies every six months and then annually if remission is achieved. Figure: Gastric Body lesion - Biopsy confirmed MALT Lymphoma Figure: Gastric Body/Antrum junction Lesions 1 & 2"

Dyspepsia • Extranodal Marginal Zone Lymphoma • Hematological Malignancies • Infectious Disease • Lymphoma • Marginal Zone Lymphoma • MALT1

EXPERIENCE WITH RIFABUTIN-CONTAINING THERAPY IN 900 PATIENTS FROM THE EUROPEAN REGISTRY ON HELICOBACTER PYLORI MANAGEMENT (HP-EUREG) (UEGW 2026) - No abstract available

Clinical • Infectious Disease

Drug Resistance Patterns, Temporal Trends, and Risk Factors Among Elderly Tuberculosis Patients in Anhui, China: A Retrospective Study (2020-2024). (PubMed, Infect Drug Resist) - "Conversely, resistance to rifabutin, moxifloxacin, levofloxacin, and para-aminosalicylic acid increased (all P < 0.05). Despite declining INH resistance, the rising resistance to fluoroquinolones and secondary agents demands vigilance. Policymakers should prioritize targeted screening for high-risk cohorts and integrated comorbidity management to optimize therapeutic outcomes and curb regional transmission."

Journal • Retrospective data • Geriatric Disorders • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

MIC-based tuberculosis drug susceptibility testing using Sensititre MYCOTB: a diagnostic accuracy meta-analysis. (PubMed, J Clin Microbiol) - "Amikacin, kanamycin, and ofloxacin demonstrate good diagnostic accuracy, with high specificity (>0.98 [95% CI]). Moderate diagnostic accuracy was observed for ethambutol, streptomycin, ethionamide, and rifabutin...Sensititre MYCOTB DST demonstrates high diagnostic accuracy for MDR-TB and pre-XDR-TB drugs, while caution is required with cycloserine, moxifloxacin, and para-aminosalicylic acid. These findings support the integration of MIC-based testing into clinical decision-making."

Journal • Retrospective data • Review • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Rifabutin Loaded Biogenic Silver Nanoparticles: Development, Characterization, and Evaluation of Antidiabetic Activity in Streptozotocin Induced Diabetic Rats. (PubMed, Chem Biodivers) - "Oral administration of Rifabutin-AgNPs (5 and 10 mg/kg) for 14 days produced a significant, dose-dependent reduction in blood glucose levels, improved serum lipid profiles, and normalized hepatic transaminase (SGOT and SGPT) activities compared with untreated diabetic controls. The superior therapeutic efficacy of Rifabutin-AgNPs over pure rifabutin highlights the potential of this green synthesized nanoformulation as an efficient platform for diabetes management at the chemical biological interface."

Journal • Preclinical • Diabetes • Metabolic Disorders