Short-duration furazolidone therapy in combination with amoxicillin, bismuth subcitrate, and omeprazole for eradication of <i>Helicobacter pylori</i>

• Published in: The Saudi Journal of Gastroenterology
• Main Authors: Hasan Salman, Vahid Vahabzadeh, Reza Pahlvanzadah, Roham Salman
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-01-01
• Subjects: Eradication; furazolidone; <i> Helicobacter pylori</i>
• Online Access: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2010;volume=16;issue=1;spage=14;epage=18;aulast=Hasan
• ISSN: 1319-3767; 1998-4049

<b>Background/Aim:</b> Resistance to metronidazole is one of the most common reasons for <i>Helicobacter pylori</i> 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&#x2032;s side effects.<b> Aim:</b> To study the efficacy and side effects of furazolidone when given for 1 week in combination with bismuth subcitrate, amoxicillin, and omeprazole.<b> Materials and Methods:</b> One hundred and seventy-seven patients with duodenal ulcer were randomly divided into two groups. Group I received omeprazole 2 &#935; 20 mg &#x002B; amoxicillin 2 &#935; 1 g &#x002B; bismuth subcitrate 4 &#935; 120 mg for 2 weeks, with furazolidone 2 &#935; 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 <i>H pylori</i>. <b> Results:</b> 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&#x0025; and 79.3&#x0025; in group I and 86.6&#x0025; and 74.4&#x0025; in group II, respectively. <b> Conclusion:</b> 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 <i>H pylori</i>. Adding metronidazole to the above regimen does not increase the eradication rate.