One‐week versus two‐week furazolidone‐based quadruple therapy as the first‐line treatment for <i>Helicobacter pylori</i> infection in Iran

Daghaghzadeh, Hamed; Emami, Mohammad Hasan; Karimi, Somayeh; Raeisi, Mohammad

doi:10.1111/j.1440-1746.2007.05029.x

Cited by 17 publications

(17 citation statements)

References 36 publications

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“…[49][50][51][52][53][54] Ranitidine bismuth citrate (RBC)-based triple therapy was just as effective as the PPI-based triple regimens (P = 0.06); however, there were only two studies including a small number of patients. 55,62 Triple regimens consisting of bismuth compound (subsalicylate or colloidal bismuth subcitrate) + F + one other antibiotic, without PPI or H2-receptor antagonists, obtained a significantly higher PER (P = 0.0002) than the PPI-based triple regimens (Table 1). 30,31,38,[56][57][58][59]61,65,75 Quadruple regimens given as primary treatment are more efficient than the standard triple regimens (P = 0.01; Table 1).…”

Section: Primary Treatment and Triple Therapiesmentioning

confidence: 99%

“…30,32,35,36,38,[42][43][44][45]47,52,55,[60][61][62]64,69 Regimens lasting for 14 days achieved a rate of 79.0% (CI 65.8-89.1, P = 0.27 vs 7 day and P = 0.0001 vs 3-5 days of treatment). 37,[39][40][41]54,56,63,66 The correlation between the eradication rate and the treatment duration was positive (r = 0.22).…”

Section: Factors Influencing the Rate Of Helicobacter Pylori Eradicationmentioning

confidence: 99%

“…30,31,38,[56][57][58][59]61,65,75 Quadruple regimens given as primary treatment are more efficient than the standard triple regimens (P = 0.01; Table 1). 37,46,[60][61][62]66 Other therapies Furazolidone monotherapy, administered for 3-4 weeks, was efficient in 60-80% of the cases; 20,21,75,77 however, a rapid recolonization was observed in one study. 22 Double therapy with cimetidine + F 'cleared the infection' in 18% of the cases, 72 while omeprazole + F achieved eradication in only 50% (CI 27.2-72.8) of the patients.…”

Section: Primary Treatment and Triple Therapiesmentioning

confidence: 99%

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Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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Several aspects of Helicobacter pylori eradication have been meta-analyzed; however, nitrofuran-based therapies constitute an exception. The aim of this study was the systematic review and meta-analysis of the effect of furazolidone-and nitrofurantoin-based regimens in the eradication of infection. Studies evaluating the effects of nitrofurans on H. pylori were identified from Medline, EMBASE, the Cochrane Controlled Trials Register and congress abstracts. The studies were classified into groups based on first-, second-and third-line regimens. The pooled eradication rates and combined odd ratios of the individual studies were calculated and compared with the published meta-analysis. The factors influencing the efficiency of the regimens were also analyzed. Side-effects of nitrofuranbased regimens were also analyzed. The pooled eradication rate of primary proton pump inhibitor-based regimens containing furazolidone was 76.3% .2). The odds ratio for furazolidone-based regimens versus standard triple therapies was 2.34 (CI 0.76-3.92). Ranitidine bismuth citrate + furazolidone-based triple regimens were equally efficient (83.5%, CI 74.0-93.0, P = 0.06 versus triple therapies). Schedules including a H2 antagonist + furazolidone + one other antibiotic achieved pooled eradication rates of 79.9% (CI 67.8-89.9, P = 0.04). Bismuth-based triple therapies achieved 84.5% (CI 72.6-93.0, P = 0.002). Primary quadruple regimens containing furazolidone were superior to triple therapies (83.4%, CI 69.7-92.3, P = 0.01). Second-line schedules containing furazolidone obtained eradication rates of 76.1% (CI 66.4-85.0, P = 0.28 versus primary regimens). Third-line 'rescue' therapies were efficient in 65.5% of the cases (CI 56.3-75.5, P = 0.0001). Side-effects of the regimens containing furazolidone were more frequent than in standard therapies (P = 0.02). The combined odds ratio of side-effects for furazolidonebased versus standard therapies was 0.74 (CI 0.32-1.98). The duration of treatment, but not the furazolidone dose, influenced the treatment outcome. Primary triple regimens containing furazolidone are slightly less efficient than the standard primary combinations; primary quadruple regimens were more efficient than triple therapies. Furazolidone is also efficient as a component of second-line or rescue therapies.

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Section: Primary Treatment and Triple Therapiesmentioning

confidence: 99%

Section: Factors Influencing the Rate Of Helicobacter Pylori Eradicationmentioning

confidence: 99%

Section: Primary Treatment and Triple Therapiesmentioning

confidence: 99%

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Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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“…Its use is now essentially limited to developing countries, due to the low costs of this drug [56]; its widespread use cannot be recommended, given the high variable rate of eradication, ranging from 52% to 90% and the development of side effects including nausea, vomiting, headache, and malaise in up to one third of patients [57][58][59][60][61].…”

Section: Non Clarithromycin Based Regimensmentioning

confidence: 98%

Recent Advances in the Treatment of Helicobacter pylori Infection

Bergamaschi

Magrini²,

Pietroiusti³

2007

PRI

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The approach to the treatment of Helicobacter pylori infection has changed during the last years. In fact, during the last decade, the success rate of usual eradication regimens, based on a proton pump inhibitor plus clarithromycin associated with amoxicillin or metronidazole, declined from over 90% to about 80%, a critical threshold under which the eradication rate is considered unsatisfactory, according to current guidelines. This finding is mainly due to the raising prevalence of clarithromycin resistance, which is in turn linked to the widespread use of this antibiotic for respiratory tract infections. Therefore, obtaining a personal history negative for a previous use of macrolides is now mandatory, before administering clarithromycin-based antibiotic therapy. Should history data be uncertain, local resistance rates (if available) may be considered, with levels higher than 20% precluding the use of clarithromycin. In this case, alternative antibiotic combinations, previously used in the rare instances of failure of clarithromycin-based therapy, should be used. We examined also the possible additional beneficial effect of some novel non antibiotic agents such as lactoferrin, probiotics and natural substances. Other advances in the treatment of the infection are represented by the discovery that some extragastric disorders such as unexplained iron deficiency anemia and idiopathic thrombocytopenic purpura, may be causally linked to Helicobacter pylori, and that eradication therapy may lead to their regression in many cases. Finally, some "gray areas" (nonulcer dyspepsia, concomitant use of nonsteroidal anti-inflammatory drugs) which are the subject of debate as far the indication to treatment is concerned, have been discussed.

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“…Furazolidone has been used in nine quadruple therapies in Iran [23,27,[47][48][49][78][79][80][81] , four of which showed optimal efficacy, although severe side effects were reported in 14-d regimens. Low dose Furazolidone was used in a further study, which led to significant decline in eradication rate [80] .…”

Section: Furazolidonementioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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One‐week versus two‐week furazolidone‐based quadruple therapy as the first‐line treatment for Helicobacter pylori infection in Iran

Abstract: This is an encouraging report showing a therapy with possible success in decreasing the duration of H. pylori infection as well as reaching the eradication rate of 80%.

Cited by 17 publications

References 36 publications

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Recent Advances in the Treatment of Helicobacter pylori Infection

Helicobacter pylorieradication in West Asia: A review

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