A Furazolidone-Based Quadruple Therapy for Helicobacter Pylori Retreatment in Patients With Peptic Ulcer Disease

Eisig, Jaime Natan; Silva, Fernando Marcuz; Navarro–Rodriguez, Tomás; Hashimoto, Cláudio; Barbuti, Ricardo Correa

doi:10.1590/s1807-59322005000600010

Cited by 21 publications

(18 citation statements)

References 19 publications

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“…Asian and European studies have reported a relatively high incidence of adverse effects (31.4%-35%) [10,24,25] . Conversely, two South American [26,27] studies have shown fewer undesirable symptoms when compared to the previously mentioned studies. In the present study, despite a comparable incidence of adverse effects during treatment, only three patients had severe symptoms demanding treatment discontinuation.…”

Section: Discussionmentioning

confidence: 78%

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Felga¹,

Silva²,

Barbuti³

et al. 2008

WJG

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AIM:To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole, bismuth subcitrate, furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success. METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens. The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for 7 d. Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori ) (rapid urease test and histology). Safety was determined by the presence of adverse effects. RESULTS: Fifty-one patients were enrolled. The eradication rate was 68.8% (31/45). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effects. C O N C L U S I O N :T h e a s s o c i a t i o n o f b i s m u t h , furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens. It is an effective, cheap and safe option for salvage therapy of positive patients.

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Section: Discussionmentioning

confidence: 78%

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Felga¹,

Silva²,

Barbuti³

et al. 2008

WJG

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“…Quadruple regimens where metronidazole is replaced by furazolidone have been used in Brazil and other countries in South America to treat patients who are refractory to classic triple therapy (43,86,181) . In Brazil, the quadruple regimen recommended for retreatment is to administer a standard dose of proton pump inhibitor, amoxicillin + 1.0 g (or doxycycline 100 mg) + furazolidone 200 mg + 240 mg colloidal bismuth subcitrate (2 comp.…”

Section: Statement 30mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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“…Moreover, this drug has no cross-resistance potential to metronidazole [176] . Triple therapy in which furazolidone is used instead of metronidazole achieves high eradication rates, even in populations with a high prevalence of nitroimidazole resistance [179][180][181][182] . In this respect, a recent study has evaluated furazolidone-based triple therapy (combined with bismuth and tetracycline) in the eradication of H pylori resistant to metronidazole, with favorable results (86% eradication rate) [183] .…”

Section: Furazolidone-based Rescue Regimensmentioning

confidence: 99%

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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Helicobacter pylori (H pylori ) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a "rescue" treatment depends on which treatment is used initially. If a clarithromycinbased regimen was used initially, a subsequent metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacinbased combination would be a third "rescue" option. Alternatively, it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, a quadruple regimen may be reserved as a third-line rescue option. Finally, rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H pylori eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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A Furazolidone-Based Quadruple Therapy for Helicobacter Pylori Retreatment in Patients With Peptic Ulcer Disease

Cited by 21 publications

References 19 publications

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

“Rescue” regimens after Helicobacter pylori treatment failure

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