Furazolidone-based triple therapy for H pylori gastritis in children.
OBJECTIVE
To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis.


METHODS
A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive (13)C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone (100 mg, 200 mg if over 30 kg) twice daily. Eradication of H pylori was assessed two months after treatment by histology and (13)C -urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment.


RESULTS
Thirty-eight patients (24 females, 14 males) were included. Their age ranged from 4 to 17.8 (mean 10.9 +/- 3.7) years. On intent-to-treat analysis (n = 38), the eradication rate of H pylori was 73.7% (95% CI, 65.2%-82%) whereas in per-protocol analysis (n = 33) it was 84.8% (95% CI, 78.5%-91%). All the patients with duodenal ulcer (n = 7) were successfully treated (100% vs 56.2% with antral nodularity). Side effects were reported in 26 patients (68.4%), mainly vomiting (14/26) and abdominal pain (n = 13). Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of H pylori-positive patients after six months of treatment.


CONCLUSIONS
Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.
Kawakami
Elisabete
E
Peptic Diseases Outpatient Clinic, Pediatric Gastroenterology Division, Universidade Federal do São Paulo/Escola Paulista de Medicina, São Paulo SP, Brazil.
Machado
Rodrigo Strehl
RS
Ogata
Silvio Kazuo
SK
Langner
Marini
M
Fukushima
Erika
E
Carelli
Anna Paula
AP
Bonucci
Vania Cláudia Guimarães
VC
Patricio
Francy Reis Silva
FR
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000382:microbiology; D005260:Female; D005664:Furazolidone / Q000009:adverse effects / Q000627:therapeutic use*; D005756:Gastritis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D005664:Furazolidone; D017291:Clarithromycin; D009853:Omeprazole