A modified bismuth-containing quadruple therapy including a short course of furazolidone for Helicobacter pylori eradication after sequential therapy failure

Helicobacter. 2012 Aug;17(4):264-8. doi: 10.1111/j.1523-5378.2012.00946.x. Epub 2012 Apr 9.

Abstract

Background: Helicobacter pylori eradication has still remained a challenge, especially in case of failure to novel treatments. Therefore, we designed a study to evaluate the effects of a modified bismuth-containing quadruple therapy including a short course of furazolidone on a group of patients whose sequential therapy had been unsuccessful.

Materials and methods: Thirty-six H. pylori-positive patients who had previously failed a clarithromycin-containing sequential therapy enrolled the study. They received pantoprazole (40 mg-bid), amoxicillin (1 g-bid), and bismuth subcitrate (240 mg-bid) for 2 weeks and furazolidone (200 mg-bid) just during the first week. Eight weeks after treatment, H. pylori eradication was reassessed using C14-urea breath test.

Results: Thirty five patients completed the study. H. pylori eradication rates were 80.6% (95% CI = 67.6-93.5) and 82.9% (95% CI = 70.6-95.2) according to intention-to-treat and per-protocol analyses, respectively. All patients had excellent compliance to treatment, and no one interrupted therapy owing to adverse effects.

Conclusion: Regarding the eradication rate (>80%), low price, and very low adverse effects, a 2-week bismuth-containing quadruple regimen including a short course of furazolidone can be an encouraging regimen for second-line H. pylori eradication in case of sequential therapy failure. Possibly, it can be improved by alterations in dose, dosing intervals, and/or duration.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use
  • Adolescent
  • Adult
  • Aged
  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Bismuth / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Furazolidone / therapeutic use*
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / drug effects
  • Helicobacter pylori / physiology
  • Humans
  • Male
  • Middle Aged
  • Pantoprazole
  • Treatment Failure
  • Treatment Outcome
  • Young Adult

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Furazolidone
  • Amoxicillin
  • Pantoprazole
  • Bismuth