Short-duration furazolidone therapy in combination with amoxicillin, bismuth subcitrate, and omeprazole for eradication of Helicobacter pylori.

Background/Aim: Resistance to metronidazole is one of the most common reasons for Helicobacter pylori treatment failure with the classic triple therapy. The clarithromycin-based regimen is not cost-effective for use in developing countries. Though furazolidone is a great substitute it has many side...

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Publicado en:Saudi Journal of Gastroenterology Vol. 16; no. 1; pp. 14 - 19
Autores principales: Hasan SR, Vahid V, Reza PM, Roham SR
Formato: clinical trial research tables/charts Journal Article
Publicado: Wolters Kluwer India Pvt Ltd Jan2010
Acceso en línea:Ver este registro en EBSCOhost
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        13193767
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      dt: Jan2010
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      pub: Wolters Kluwer India Pvt Ltd
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        105295716
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        10.4103/1319-3767.58762
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        atl: Short-duration furazolidone therapy in combination with amoxicillin, bismuth subcitrate, and omeprazole for eradication of Helicobacter pylori.
      aug:
        au:
          Hasan SR
          Vahid V
          Reza PM
          Roham SR
        affil: Department of Internal Medicine, Tehran University of Medical Science Research Center, Tehran
      sug:
        subj:
          Antibiotics Administration and Dosage
          Antibiotics Adverse Effects
          Cost Benefit Analysis
          Developing Countries
          Helicobacter Infections Drug Therapy
          Biopsy
          Clinical Trials
          Demography
          Endoscopy
          Human
          Iran
          Random Assignment
      ab: Background/Aim: Resistance to metronidazole is one of the most common reasons for Helicobacter pylori treatment failure with the classic triple therapy. The clarithromycin-based regimen is not cost-effective for use in developing countries. Though furazolidone is a great substitute it has many side effects. Decreasing the duration of treatment with furazolidone to 1 week may help decrease the drug's side effects. Aim: To study the efficacy and side effects of furazolidone when given for 1 week in combination with bismuth subcitrate, amoxicillin, and omeprazole. Patients and Methods: One hundred and seventy-seven patients with duodenal ulcer were randomly divided into two groups. Group I received omeprazole 2x 20 mg+ amoxicillin 2x 1 g+ bismuth subcitrate 4x 120 mg for 2 weeks, with furazolidone 2x 200 mg in the first week only. Group II received the same regimen, except that 1 week of furazolidone was followed by 1 week of metronidazole in the second week. Control endoscopy was performed after 6 weeks. Three biopsies from the antrum and three from the corpus were taken for urease testing and histology. Eradication was concluded if all tests were negative for H pylori. Results: One hundred and fifty-seven patients completed the study. Two subjects from group I and three from group II did not tolerate the regimen and were excluded from the analysis. No serious complication was detected in any patient. The eradication rates by per-protocol (PP) analysis and intention-to-treat (ITT) analysis were 89% and 79.3% in group I and 86.6% and 74.4% in group II, respectively. Conclusion: One week of furazolidone in combination with 2 weeks of amoxicillin, omeprazole, and bismuth subcitrate is a safe and cost-effective regimen for the eradication of H pylori. Adding metronidazole to the above regimen does not increase the eradication rate.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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