Helicobacter Pylori Ran Away Furazolidone-based Quadruple Therapy!

Abstract

Background: Helicobacter pylori is the main etiologic agent in most gastritis and peptic ulcers . The ideal regimen for the treatment of H. pylori infection has not yet been defined. This study was designed to evaluate the eradication rate of H. pylori infection using a short-term and cost effective furazolidone-based regimen in a previously sensitive area to furazolidone drug.

Methods: In a randomized single blinded clinical trial study, 135 patients with an endoscopically verified H. pylori-positive peptic ulcer disease were randomly assigned to a quadruple therapy of "furazolidone, 200 mg; bismuth subcitrate, 240 mg; tetracycline, 500 mg and omeprzole, 20 mg" twice daily for either 14 or 7 days. Six-eight weeks after cessation of therapy, H. pylori eradication was assessed by 13C-urea breath test.

 Results: H. pylori eradication rate in 7-day and 14-day groups were 71% and 65%, respectively using intention to treat test with no significant difference between the two groups. H. pylori eradication rate had no significant correlation with age, sex and smoking habit.

Conclusion: Our study showed that furazolidone-based regimen could not yield an acceptable eradication rate in the area sensitive to furazolidone previously. Eradication failure was attributed to several reasons including inadequate choice of drugs, insufficient knowledge of best therapeutic choices; poor patients' adherence to treatment and primary H. pylori resistance to the most commonly employed antibiotics.