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

Hasan, Salman Roughani; Vahabzadeh, Vahid; Reza, Pahlvanzadah M; Roham, Salman R

doi:10.4103/1319-3767.58762

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…achieved relatively poor results with PP ranging from 56% to 85.7% (weighted mean for PP and ITT were 71% and 67%, respectively, Table 1). There were 4 studies [32;37;41;42] using a sequential therapy with furazolidone 200 mg b.i.d. given for the first week of a two week therapy.…”

Section: Resultsmentioning

confidence: 99%

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

et al. 2017

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Background Treatment success of H. pylori eradication therapy has declined worldwide largely because of increased antimicrobial resistance. New therapeutic approaches are needed, especially for countries like Iran, where resistance to commonly used drugs is already widespread and traditional H. pylori therapies produce poor cure rates. Aim to review the results of quadruple therapy trials containing bismuth and furazolidone in Iran. Methods We searched PubMed, Google scholar as well as the references of all published papers for studies done in Iran, utilizing furazolidone in the treatment of H. pylori infections. The target population was 4 drug studies that utilized a combination of bismuth, furazolidone, amoxicillin, or tetracycline plus a proton pump inhibitor. Results Eighteen studies with 22 arms including 1713 subjects were found. The weighted mean cure rate for 14-day studies (6 studies) using 200 mg b.i.d. furazolidone was 80% intention-to-treat (ITT) and 87% per protocol (PP). Studies using 100 mg b.i.d (3 studies) were less effective (weighted mean ITT cure rate = 67%). One small 14 day study with furazolidone 100 mg q.i.d. achieved cure rates of 94.5% ITT and PP. Conclusions Although furazolidone-bismuth quadruple therapy proved relatively effective in Iran, furazolidone-containing regimens remain to be optimized. Based on these data and results from China, it appears likely that 14 day therapy containing furazolidone 100 mg t.i.d. or q.i.d. is likely to provide the highest cure rates with lowest side effects; this remains to be experimentally tested. Detailed suggestions for further development of furazolidone-containing regimens are provided.

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Section: Resultsmentioning

confidence: 99%

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

et al. 2017

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“…[18,19] The major limitation for widespread use of FZD appears because of its side effects related to digestive tract, such as nausea, anorexia, dizziness, abdomen discomfort etc., which are due to monoamine oxidase inhibitory effects of this drug. [20] Additionally, doses and duration of FZD also affect the incidence of side effects. [16] A study compare the incidence of adverse reactions with 14-day regimens containing FZD has found that as the dose increases from 100 to 200 mg (twice a day), the severe or intolerant side effects leading to the discontinuation of treatment increased from 6% to 20%, including dizziness, abdominal pain, and anorexia.…”

Section: Discussionmentioning

confidence: 99%

Comparison the cost-efficacy of furazolidone-based versus clarithromycin-based quadruple therapy in initial treatment of Helicobacter pylori infection in a variable clarithromycin drug-resistant region, a single-center, prospective, randomized, open-label study

Yi¹,

Yang²,

Chao³

et al. 2019

Medicine

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Helicobacter pylori (Hp) drug resistant rate to clarithromycin (CLA) has increased to 20% to 50%, which cause concerns regarding its effectiveness in eradicating Hp, we aim to evaluate the cost-effectiveness of CLA-based versus furazolidone (FZD)-based quadruple therapy, and assess factors that affect anti-Hp efficacy. One hundred eighty-five patients were enrolled in this single-center, prospective, randomized, open-label study. In FZD group, 92 patients were treated with FZD plus esomeprazole, bismuth potassium citrate, and amoxicillin for 14 days. In CLA group, 93 patients were treated with the same regimen except FZD was replaced by CLA. Patients were tested 4 weeks post-treatment to confirm eradication. Of the 185 enrolled patients, 180 completed the study. On intention-to-treat analysis, Hp eradication rates in FZD and CLA groups were 90.22% and 86.02% ( P = .378); in per-protocol analysis, their eradication rates were 93.26% and 87.91%, respectively ( P = .220). Overall incidence of total side effects in FZD and CLA groups was 19.57% and 13.98%, and their severe side effects were 3.26% and 2.15%, respectively ( P > .05). Cost-effectiveness ratios of FZD and CLA groups were 0.75 and 1.02, and incremental cost-effectiveness ratio of FZD group over CLA group was −3.62. Eradication failures were not associated with factors including gender, age, body mass index, smoking, alcohol consumption, educational level, and urban–rural distribution in this observation ( P > .05). Despite increasing drug resistance to CLA, Hp eradication rates in FZD and CLA groups have no significant difference at present; as FZD-based quadruple therapy is more cost-effective, we recommend this regimen be a first-line choice for Hp eradication.

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“…Many researchers have reported high levels of resistance to metronidazole (37%) and clarithromycin (28%) (2,3,(7)(8)(9)(10)(11). Fakheri et al (12), in a study, showed that furazolidone-based quadruple therapy is a good alternative for eradication of H. pylori infection in regions with high resistance to metronidazole and clarithromycin.…”

Section: Introductionmentioning

confidence: 99%

“…Given the high pill burden, the increased frequency of administration, and the prolonged duration of treatment, a thorough understanding of the importance of completing the treatment regimen, as prescribed, is paramount, and we can improve our patients' compliance and H. pylori eradication rate by encouraging and assuring patients. However, choosing the treatment should be based on regional patterns of drug susceptibility and resistance and other factors such as a history of recent taking antibiotics (2,11,14,15,(17)(18)(19).…”

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confidence: 99%

Comparison of Clarithromycin-based Triple Therapy and Furazolidone-based Quadruple Therapy in Eradicating Helicobacter pylori Infection

et al. 2021

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Background: Helicobacter pylori infection is the most common infection of human. This organism is responsible for the majority of peptic ulcer diseases, MALToma and gastric cancer, worldwide. Several regimen therapies against H. pylori had developed and are prescribed empirically, but therapies have rarely been optimized. Objectives: In this study, we compared two regimens that are widely used in Iran, triple regimen (clarithromycin, amoxicillin, and omeprazole) and furazolidone-based quadruple regimen (furazolidone, amoxicillin, bismuth, and omeprazole) in some dyspeptic patients. Methods: In this cross-sectional study, 373 consecutive dyspeptic patients that H. pylori infection was established, randomized into one of the following groups; 188 in group A (treated with clarithromycin 500 mg, amoxicillin 1,000 mg, and omeprazole 20 mg twice daily for 10 days) and 185 in group B (furazolidone 200 mg, amoxicillin 1000 mg, bismuth subcitrate 240 mg and omeprazole 20 mg twice daily for 14 days). One month after discontinuation of the treatment, H. pylori eradication was evaluated with UBT. Results: Mean age of the patients was 35.9 ± 12.3 years, and the male to female ratio was 1: 1.6. In the per-protocol analysis, the eradication rate of H. pylori was 63.7% in comparison to 93% in group A and B, respectively (P < 0.004). Conclusions: Our study showed furazolidone-based quadruple regimen is superior to the standard triple regimen; thus, it is recommended as the first choice.

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

Cited by 11 publications

References 22 publications

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

Comparison the cost-efficacy of furazolidone-based versus clarithromycin-based quadruple therapy in initial treatment of Helicobacter pylori infection in a variable clarithromycin drug-resistant region, a single-center, prospective, randomized, open-label study

Comparison of Clarithromycin-based Triple Therapy and Furazolidone-based Quadruple Therapy in Eradicating Helicobacter pylori Infection

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