title: One-week omeprazole, furazolidone and amoxicillin rescue therapy after failure of Helicobacter pylori eradication with standard triple therapies.
abstract: OBJECTIVE
  To test the efficacy of omeprazole, furazolidone and amoxicillin triple therapy for the treatment of Helicobacter pylori infection after failure of standard first-line therapy recommended by the Asia-Pacific Consensus on the management of H. pylori infection.
  
  
  METHODS
  Patients with failed H. pylori eradication received omeprazole, 20 mg, furazolidone, 100 mg, and amoxicillin, 1 g, all twice daily for 1 week. Endoscopy (CLO test, histology and culture) was performed before treatment. Post-treatment H. pylori status was determined by 13C-urea breath test 6 weeks later.
  
  
  RESULTS
  Fifty patients were recruited. Resistance to metronidazole, clarithromycin and both drugs was in the range of 50-64%, 60-75% and 40-50%, respectively, after failure of first-line therapy. Amoxicillin resistance was not found. The intention-to-treat and per protocol H. pylori eradication rates were 52% and 53%, respectively. Patients with double resistance to metronidazole and clarithromycin showed the lowest eradication rate (38%), which was significantly lower than that of patients with sensitive strains (88%). Side-effects were minimal and compliance was excellent (98%).
  
  
  CONCLUSIONS
  One-week omeprazole, furazolidone and amoxicillin rescue therapy achieved a high eradication rate in strains sensitive to metronidazole and clarithromycin. This is a cheap and safe rescue regimen when guided by pre-treatment sensitivity testing.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: W M
authors.initials: WM
authors.lastname: Wong
authors.forename: B C Y
authors.initials: BC
authors.lastname: Wong
authors.forename: H
authors.initials: H
authors.lastname: Lu
authors.forename: Q
authors.initials: Q
authors.lastname: Gu
authors.forename: Y
authors.initials: Y
authors.lastname: Yin
authors.forename: W H
authors.initials: WH
authors.lastname: Wang
authors.forename: F M Y
authors.initials: FM
authors.lastname: Fung
authors.forename: K C
authors.initials: KC
authors.lastname: Lai
authors.forename: H H X
authors.initials: HH
authors.lastname: Xia
authors.forename: S D
authors.initials: SD
authors.lastname: Xiao
authors.forename: S K
authors.initials: SK
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D005664:Furazolidone / Q000008:administration & dosage / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D017211:Treatment Failure
chemical_list: D000891:Anti-Infective Agents, Local; D000897:Anti-Ulcer Agents; D005664:Furazolidone; D000658:Amoxicillin; D009853:Omeprazole