A new quadruple therapy for Helicobacter pylori using tripotassium dicitrato bismuthate, furazolidone, josamycin and famotidine

Background: In our previous study, a triple therapy using tripotassium dici trato bismuthate (TDB), josamycin and furazolidone achieved a suboptimal cu re rate of Helicobacter pylori infection. Aim: To investigate whether the addition of an antisecretory agent raises t he cure rate using this regimen. Methods: One hundred and twenty H. pylori positive patients with peptic ulc er disease or functional dyspepsia were randomly assigned to receive 1-week quadruple therapy of TDB 240 mg b.d., furazolidone 100 mg b.d., josamycin 1000 mg b.d. and famotidine 20 mg b.d. (BFJF group), or triple therapy of T DB 240 mg b.d., furazolidone 100 mg b.d. and clarithromycin 250 mg b.d. (BF C group). H. pylori status was assessed by histology and culture of gastric biopsy specimens before and at least 4 weeks after completion of therapy. Results: Seven patients (three in the BFJF group and four in the BFC group) dropped out. Eradication rates (intention-to-treat/per protocol) were 90%/ 95% in the BFJF group and 82%/88% in the BFC group, respectively (P > 0.05) . Duodenal ulcer healing rates were 94% (16/17) in the BFJF group and 80% ( 20/25) in the BFC group, respectively (P > 0.05). Mild side-effects occurre d in 11 (18%) patients in the BFJF group and 10 (17%) in the BFC group (P > 0.05). Conclusions: One-week quadruple therapy consisting of TDB, furazolidone, jo samycin and famotidine achieves a high cure rate of H. pylori infection.