FURAZOLIDONE, AMOXICILLIN, BISMUTH TRIPLE THERAPY FOR HELICOBACTER-PYLORI INFECTION

Background: Metronidazole-resistant Helicobacter pylori are generally the rule in developing countries such as Colombia. Developing countrie s need an effective, simple and inexpensive non-metronidazole therapy for H. pylori infection.Aim: To evaluate the combination of bismuth, f urazolidone and amoxycillin for the treatment of H. pylori infection i n Colombia. Methods: Thirty patients with histologically documented H. pylori infection received the combination of bismuth subcitrate 240 m g b.d., furazolidone 100 mg q.d.s. and amoxycillin 500 mg q.d.s. for 1 4 days. Four or more weeks after ending therapy patients were re-endos coped and gastric biopsies were obtained and examined using the Genta stain. Each slide was scored for presence, absence and density of H. p ylori, active and chronic inflammation, intestinal metaplasia, erosion s and atrophy. Cure was defined as the absence of H. pylori. Results: All patients completed the course of therapy. Twenty-five patients wer e cured (86%, 95% CI: 65-94%). Mild, well-tolerated side-effects were reported by six patients (20%). Conclusions: This combination of bismu th, furazolidone and amoxycillin fulfills the criteria for successful H. pylori therapy and appears particularly well suited for developing countries since it is simple, inexpensive and effective. Furazolidone- containing therapies may become especially useful in the face of a wor ld-wide increase in H. pylori resistance to metronidazole and macrolid es.