Furazolidone‐based triple ‘rescue therapy’ vs. quadruple ‘rescue therapy’ for the eradication of <i>Helicobacter pylori</i> resistant to metronidazole

Isakov, Vasily; Domareva, I.; Koudryavtseva, L.; Маев, И. В.; Ganskaya, Z.

doi:10.1046/j.1365-2036.2002.01299.x

Cited by 54 publications

(53 citation statements)

References 23 publications

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“…Several studies have shown the efficacy of regimens containing a high-dose furazolidone (200 mg, b.i.d. ) as the therapy in patients with H pylori infection [20][21][22] . The study of Fakheri et al showed that low-dose furazolidone (100 mg, b.i.d.)…”

Section: Discussionmentioning

confidence: 99%

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Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

Cheng

Hu²

2009

WJG

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AIM:To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori (H pylori ). METHODS:Patients who failed in the H pylori eradication therapy for at least one course were randomly allocated into three groups. Group A received rebaprazole 10 mg + amoxicillin 1 g + furazolidone 100 mg, and bismuth subcitrate 220 mg, twice daily for 1 wk; group B received the same regimen of group A but for 2 wk; and group C received the same regimen of group B, but furazolidone was replaced by furazolidone 100 mg three times daily. To record the side effect profiles at the end of the treatment, H pylori eradication was assessed with 13 C-urea breath test 4 wk after therapy. RESULTS:Sixty patients were enrolled including 28 males, and 20 patients in each group. The average age of the patients was 49.2 years, ranging from 18 to 84 years. H pylori eradication rates with per-protocol analysis were 82%, 89% and 90% in the three groups, respectively. Side effects were found in 11 patients, including mild dizziness, nausea, diarrhea and increased bowel movement. None of the 11 patients needed treatment for their side effects. CONCLUSION:One-or two-week furazolidone and amoxicillin-based quadruple rescue therapy with a low dose furazolidone (100 mg bid ) for the eradication of H pylori is effective. Extending the antibiotic course to 14 d could improve the eradication rates.

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Section: Discussionmentioning

confidence: 99%

“…Several studies showed that side effects were very common (more than 20%) in the patients who received treatment with furazolidone-based regimens [13] , especially with high-dose furazolidone of 200 mg b.i.d. [24,26] . A major problem with furazolidone at high doses is the high rate of severe side effects.…”

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confidence: 99%

Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

Cheng

Hu²

2009

WJG

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“…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] . A few years ago, some authors tested a quadruple combination of furazolidone, bismuth, tetracycline and PPI as a second-line eradication therapy, and reported encouraging results [184] .…”

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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“…7 Nevertheless, bacterial eradication may fall in up to 40% of cases after the suggested second-line regimens and doctors who treat this infection are often faced with a certain number of patients for whom two treatment attempts have failed. [10][11][12][13][14] Furthermore, a progression of H. pylorirelated chronic active gastritis towards atrophy, intestinal metaplasia and gastric cancer has also been reported suggesting that further attempts to cure the infection are worthwhile. 15 Currently, a standard thirdline treatment is lacking, and European guidelines recommend culture in these patients to select a thirdline treatment according to microbial sensitivity to antibiotics.…”

Section: Introductionmentioning

confidence: 99%

A 10‐day levofloxacin‐based triple therapy in patients who have failed two eradication courses

Gatta

Zullo

Perna

et al. 2005

Aliment Pharmacol Ther

109

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Background: A standard third-line treatment is lacking, and European guidelines recommend performing culture in these patients. However, the use of this procedure as 'routine practice' is definitively not feasible. Aim: To evaluate the eradication rate of a 10-day levofloxacin-based triple therapy in patients who have failed two eradication courses for Helicobacter pylori. Methods: A total of 151 patients with persistent Helicobacter pylori infection after two treatments were studied. Patients were considered positive if two of three endoscopic tests were positive. Susceptibility testing was also performed. Patients received a standard dose of

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Furazolidone‐based triple ‘rescue therapy’ vs. quadruple ‘rescue therapy’ for the eradication of Helicobacter pylori resistant to metronidazole

Cited by 54 publications

References 23 publications

Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

“Rescue” regimens after Helicobacter pylori treatment failure

A 10‐day levofloxacin‐based triple therapy in patients who have failed two eradication courses

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