title: Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population.
abstract: BACKGROUND
  In Iran, there is insufficient information on the efficacy of Helicobacter pylori eradication regimens shorter than 10 days. This study aims at assessing the efficacy of 4- and 7-day H. pylori eradication regimens in a high-incidence area of gastric cancer in Iran.
  
  
  METHODS
  Subjects with an endoscopic diagnosis of gastritis, positive urease test, and a histological diagnosis of chronic gastritis were enrolled. Patients were randomly assigned to one of three groups: AOC7 (1000 mg amoxicillin, 20 mg omeprazole, and 500 mg clarithromycin twice daily for 7 days), FOT4 (200 mg furazolidone, 20 mg omeprazole, and 500 mg tetracycline twice daily for 4 days) and FOT7 (the same treatment as the FOT4 group but for 7 days). Sensitivity to these antibiotics was determined in all isolates recovered from culture. The efficacy of eradication was assessed 8 weeks after the end-of-treatment by the 14C-urea breath test.
  
  
  RESULTS
  One hundred and twenty-eight patients were enrolled in the study. Culture was positive for 84 patients and none of these were resistant to amoxicillin, tetracycline or furazolidone, 1.2% were resistant to clarithromycin and 32.1% to metronidazole. Forty-five, 41 and 42 patients were randomly allocated to the AOC7, FOT4, and FOT7 groups, respectively. The intention-to-treat eradication rates were 35.5, 17.1, and 23.8% for the AOC7, FOT4, and FOT7 groups, respectively.
  
  
  CONCLUSIONS
  Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile.
authors.affiliation: Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran and Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: Shahin
authors.initials: S
authors.lastname: Merat
authors.forename: Mohammad-Hassan
authors.initials: MH
authors.lastname: Derakhshan
authors.forename: Farideh
authors.initials: F
authors.lastname: Siavoshi
authors.forename: Abbas
authors.initials: A
authors.lastname: Yazdanbod
authors.forename: Javad
authors.initials: J
authors.lastname: Mikaeli
authors.forename: Rasoul
authors.initials: R
authors.lastname: Sotoudemanesh
authors.forename: Masoud
authors.initials: M
authors.lastname: Sotoudeh
authors.forename: Mohammad-Jafar
authors.initials: MJ
authors.lastname: Farahvash
authors.forename: Siavosh
authors.initials: S
authors.lastname: Nasseri-Moghaddam
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.forename: Shahab
authors.initials: S
authors.lastname: Dolatshahi
authors.forename: Behnoosh
authors.initials: B
authors.lastname: Abedi
authors.forename: Masoud
authors.initials: M
authors.lastname: Babaei
authors.forename: Shahnam
authors.initials: S
authors.lastname: Arshi
authors.forename: Ali
authors.initials: A
authors.lastname: Majidpour
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations