Saudi Journal of Gastroenterology
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Year : 2010  |  Volume : 16  |  Issue : 1  |  Page : 14-18

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

1 Depatment of Internal Medicine, Yazd University of Medical Science and Health Services, Yazd, Iran
2 Yazd University of Medical Science Research Center, Yazd, Iran
3 Depatment of Microbiology and Pathology, Yazd University of Medical Science and Health Services, Yazd, Iran
4 Tehran University of Medical Science Research Center, Tehran, Iran

Correspondence Address:
Salman R Roham
Shahid Sadoghi University of Medical Sciences, Safaiyeh Ebne Sina Avenue, Shahid Sadoghi Hospital, Yazd
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.58762

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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. Materials and Methods: One hundred and seventy-seven patients with duodenal ulcer were randomly divided into two groups. Group I received omeprazole 2 Χ 20 mg + amoxicillin 2 Χ 1 g + bismuth subcitrate 4 Χ 120 mg for 2 weeks, with furazolidone 2 Χ 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.

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