Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population.
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.
Malekzadeh
Reza
R
Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran and Ardabil University of Medical Sciences, Ardabil, Iran.
Merat
Shahin
S
Derakhshan
Mohammad-Hassan
MH
Siavoshi
Farideh
F
Yazdanbod
Abbas
A
Mikaeli
Javad
J
Sotoudemanesh
Rasoul
R
Sotoudeh
Masoud
M
Farahvash
Mohammad-Jafar
MJ
Nasseri-Moghaddam
Siavosh
S
Pourshams
Akram
A
Dolatshahi
Shahab
S
Abedi
Behnoosh
B
Babaei
Masoud
M
Arshi
Shahnam
S
Majidpour
Ali
A
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
D000900:Anti-Bacterial Agents; D004338:Drug Combinations