Effect of two different doses of metronidazole and tetracycline in bismuth triple therapy on eradication of Helicobacter pylori and Its resistant strains

Roghani, H Salman; Massarrat, Sadegh; Pahlewanzadeh, Mohammadreza; Dashti, M H

doi:10.1097/00042737-199907000-00004

Cited by 33 publications

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“…In a randomized study, 2‐week treatment of Iranian duodenal ulcer (DU) patients with classic triple therapy achieved a cure rate for H. pylori infection of 46%, 12 and in another study with additional administration of ranitidine the cure rate was 55.8% only; 13 both by per protocol analysis. In another center in Iran, the cure rate in DU patients with the same regimen without ranitidine for 2 weeks was 77% by per protocol analysis 14 . These results show that the recommended regimens for H. pylori eradication are not suitable for peptic ulcer patients in Iran and probably in developing countries 9,14 , 15 .…”

Section: Introductionmentioning

confidence: 96%

“…In another center in Iran, the cure rate in DU patients with the same regimen without ranitidine for 2 weeks was 77% by per protocol analysis 14 . These results show that the recommended regimens for H. pylori eradication are not suitable for peptic ulcer patients in Iran and probably in developing countries 9,14 , 15 . It seems that special and more toxic strains of H. pylori are colonized in the gastric mucosa, which need new drug combinations for eradication.…”

Section: Introductionmentioning

confidence: 96%

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Effect of different doses of furazolidone with amoxicillin and omeprazole on eradication of Helicobacter pylori

Roghani¹,

Massarrat

Shirekhoda³

et al. 2003

J of Gastro and Hepatol

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 96%

Effect of different doses of furazolidone with amoxicillin and omeprazole on eradication of Helicobacter pylori

Roghani¹,

Massarrat

Shirekhoda³

et al. 2003

J of Gastro and Hepatol

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“…[16] About 40-70% of H pylori strains are resistant to metronidazole, which is believed to be the main cause of treatment failure. [41317–20] The increase in the prevalence of resistant strains observed in developing countries, as well as in European countries and North America, is the reason for the poor efficacy of metronidazole-based regimens. [2321–27]…”

Section: Discussionmentioning

confidence: 99%

Short-duration furazolidone therapy in combination with amoxicillin, bismuth subcitrate, and omeprazole for eradication of Helicobacter pylori

Hasan¹,

Vahabzadeh²,

Reza³

et al. 2010

Saudi J Gastroenterol

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Background/Aim:Resistance to metronidazole is one of the most common reasons for Helicobacter pylori treatment failure with the classic triple therapy. The clarithromycin-based regimen is not cost-effective for use in developing countries. Though furazolidone is a great substitute it has many side effects. Decreasing the duration of treatment with furazolidone to 1 week may help decrease the drug's side effects.Aim:To study the efficacy and side effects of furazolidone when given for 1 week in combination with bismuth subcitrate, amoxicillin, and omeprazole.Patients and Methods:One hundred and seventy-seven patients with duodenal ulcer were randomly divided into two groups. Group I received omeprazole 2 Χ 20 mg + amoxicillin 2 Χ 1 g + bismuth subcitrate 4 Χ 120 mg for 2 weeks, with furazolidone 2 Χ 200 mg in the first week only. Group II received the same regimen, except that 1 week of furazolidone was followed by 1 week of metronidazole in the second week. Control endoscopy was performed after 6 weeks. Three biopsies from the antrum and three from the corpus were taken for urease testing and histology. Eradication was concluded if all tests were negative for H pylori.Results:One hundred and fifty-seven patients completed the study. Two subjects from group I and three from group II did not tolerate the regimen and were excluded from the analysis. No serious complication was detected in any patient. The eradication rates by per-protocol (PP) analysis and intention-to-treat (ITT) analysis were 89% and 79.3% in group I and 86.6% and 74.4% in group II, respectively.Conclusion:One week of furazolidone in combination with 2 weeks of amoxicillin, omeprazole, and bismuth subcitrate is a safe and cost-effective regimen for the eradication of H pylori. Adding metronidazole to the above regimen does not increase the eradication rate.

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“…The metronidazole-based standard triple therapy regimen has been unsuccessful in H pylori eradication, yielding an eradication rate of only about 55% compared with about 90% in other countries [13,14] . This is because metronidazoleresistant H pylori strains are rather common in Iran as well as in other developing countries [9,15] .…”

Section: Discussionmentioning

confidence: 99%

Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

Seyed¹,

Amir²,

Mirbagheri³

et al. 2006

WJG

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AIM:To compare the effectiveness of triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication in a comparative threearmed randomized clinical trial. METHODS:A total of 360 H pylori -positive patients suffering from dyspepsia and aging 24-79 years with a median age of 42 years were enrolled in the study and randomly allocated into the following three groups: group A (n = 120) received a standard 1-wk triple therapy ( Chi-square test with the consideration of P < 0.05 as significant was used to compare the eradication rates by intention-to-treat and per-protocol analyses in the three groups. RESULTS:The per-protocol eradication rate was 91.81% (101 patients from a total of 110) in group A, 85.84% (97 patients from a total of 113) in group B, and 92.85% (104 patients from a total of 112) in group C. The intentionto-treat eradication rate was 84.17% in group A, 80.83% in group B, and 86.67% in group C. The new protocol yielded the highest eradication rates by both per-protocol and intention-to-treat analyses followed by the standard triple and quadruple regimens, respectively. However, the differences were not statistically significant between the three groups. CONCLUSION:The results of this study provide further support for the equivalence of triple and quadruple therapies in terms of effectiveness, compliance and sideeffect profile when administered as first-line treatment for H pylori infection. Moreover, the new protocol using ampicillin-sulbactam instead of amoxicillin in the quadruple regimen is a suitable first-line alternative to be

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Effect of two different doses of metronidazole and tetracycline in bismuth triple therapy on eradication of Helicobacter pylori and Its resistant strains

Cited by 33 publications

References 0 publications

Effect of different doses of furazolidone with amoxicillin and omeprazole on eradication of Helicobacter pylori

Effect of different doses of furazolidone with amoxicillin and omeprazole on eradication of Helicobacter pylori

Short-duration furazolidone therapy in combination with amoxicillin, bismuth subcitrate, and omeprazole for eradication of Helicobacter pylori

Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

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