Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 26  |  Issue : 2  |  Page : 78-83

Treatment with compound Lactobacillus acidophilus followed by a tetracycline- and furazolidone-containing quadruple regimen as a rescue therapy for Helicobacter pylori infection


Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Correspondence Address:
Dr. Airu Liu
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Changhai Road 168, Shanghai - 200433
China
Dr. Yiqi Du
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Changhai Road 168, Shanghai - 200433
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.SJG_589_19

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Background/Aim: Treatment of Helicobacter pylori infections has become more difficult because of increasing antibiotic resistance. We assessed the efficacy and safety of treatment with probiotics followed by a tetracycline- and furazolidone-containing quadruple regimen as rescue treatment for H. pylori infection. Patients and Methods: This retrospective study examined patients with at least two H. pylori eradication failures. Patients were given a two-week compound Lactobacillus acidophilus (1 g t.i.d.), followed by a quadruple antibiotic regimen (esomeprazole [20 mg b.i.d.] + bismuth potassium citrate [220 mg b.i.d.] + tetracycline [750 mg b.i.d.] + furazolidone [100 mg b.i.d.]) for 10 days as rescue therapy. Eradication was evaluated using the[13]C-urea breath test at 4 weeks after the end of therapy, and side effects were recorded. Results: The records of 50 patients were examined. Four cases experienced treatment failure, and one case received replacement with metronidazole because of allergy to furazolidone. The eradication rate was 92.0% [95% confidence interval (CI): 84.0–98.0%) in intention-to-treat (ITT) analysis and 91.8% (95% CI: 83.7–98.0%) in per protocol (PP) analysis. Side effects (mainly dizziness, dry mouth, and skin rash) occurred in 10 patients, all of which resolved after cessation of antibiotics. Conclusions: Patients who failed multiple attempts at H. pylori eradication may benefit from a treatment with probiotics followed by a tetracycline- and furazolidone-containing quadruple regimen.


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