Furazolidone-containing short-term triple therapies are effective in the treatment of Helicobacter pylori infection

Background: A furazolidone-containing therapeutic regimen for Helicobacter pylori infection has attracted special interest in the face of a rising wor ld-wide metronidazole resistant H. pylori, and the expense of currently use d antimicrobial regimens, Aim: To evaluate the efficacy of furazolidone-containing regimens in eradic ating H. pylori. Methods: One-hundred and forty H. pylori positive patients with endoscopica lly confirmed duodenal ulcer or functional dyspepsia received one of four d ifferent regimens to eradicate H. pylori. In the first trial, the patients were randomly assigned to receive a 1-week course of furazolidone 100 mg b. d. and clarithromycin 250 mg b.d., with either tripotassium dicitrato bismu thate (TDB) 240 mg b.d. (FCB group) or lansoprazole 30 mg daily (FCL group) . In the second trial, the patients were randomly assigned to receive a 1-w eek course of clarithromycin 250 mg b.d. and omeprazole 20 mg daily, with e ither furazolidone 100 mg b,d, (FCO group) or metronidazole 400 mg b.d. (MC O group). Endoscopy was repeated 4 weeks following completion of therapy wi th re-assessment of H. pylori status on gastric biopsies by histology and c ulture. Results: Four patients (1 in FCB, 1 in FCO and 2 in MCO groups) dropped out because they refused a follow-up endoscopy. Eradication rates of H. pylori on an intention-to-treat basis in the FCB, FCL, FCO and MCO groups were 91 % (32/35, 95% CI: 82-99%), 91% (32/35, CI: 82-99%), 86% (30/35, CI: 74-97%) and 74% (26/35, CI: 60-89%) (all P > 0.05), respectively. Mild side effect s occurred in 15% of the 140 patients. in MCO group, the eradication rate i n the patients infected with metronidazole-sensitive isolates of H. pylori was 86%, but dropped to 67% in those with metronidazole-resistance strains (P = 0.198), Conclusion: One-week regimens containing furazolidone and clarithromycin in combination with TDB or a proton pump inhibitor fulfil the criteria for su ccessful H. pylori therapy.