title: Furazolidone-based, metronidazole-based, or a combination regimen for eradication of Helicobacter pylori in peptic ulcer disease.
abstract: BACKGROUND
  Furazolidone has been effective against Helicobacter pylori in Iran, with no resistance, but with intolerable side effects in the second week. One-week regimens have not been useful here. We compared the efficacy and side effect profiles of three anti-H. pylori regimens.
  
  
  METHODS
  Patients with peptic ulcer disease and positive H. pylori infection were randomly allocated into three groups. The patients in group A received omeprazole 20 mg + amoxicillin 1g + metronidazole 500 mg, and bismuth subcitrate 240 mg twice daily each, for two weeks; the patients in group B received the same regimen but metronidazole was replaced by furazolidone 200 mg twice daily; and the patients in group C received regimen B for the first week and regimen A for the second week. H. pylori eradication was verified with 13C-urea breath test at the tenth week.
  
  
  RESULTS
  Three hundred and fourteen patients were enrolled; 107, 104, and 103 patients in groups A-C, respectively but 278 patients completed the study. Seven, three, and six patients discontinued their medication in groups A-C, respectively. Fever, dizziness, and weakness were more common in group B than group C (P < 0.05). Vomiting, pruritus, and rash were more common in group C than group A (P < 0.05). Per-protocol eradication rates were 83.1%, 95.2%, and 95.3% in groups A-C, respectively (P = 0.005, groups A and C). Intention to treat eradication rates were 74.5%, 87.0%, and 86.6% in groups A-C, respectively (P = 0.02, groups A and C).
  
  
  CONCLUSIONS
  One-week furazolidone followed by one-week metronidazole regimen is as efficient as two-week furazolidone regimen but with fewer side effects. Furazolidone-based regimens are superior to metronidazole-based ones for H. pylori eradication in Iran.
authors: Department of Gastroenterology, Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Morteza
authors: M
authors: Khatibian
authors: Yalda
authors: Y
authors: Ajvadi
authors: Siavoush
authors: S
authors: Nasseri-Moghaddam
authors: Naser
authors: N
authors: Ebrahimi-Dariani
authors: Houmayoon
authors: H
authors: Vahedi
authors: Nasrin
authors: N
authors: Zendehdel
authors: Rasoul
authors: R
authors: Sotoudehmanesh
authors: Shahram
authors: S
authors: Agah
authors: Javad
authors: J
authors: Mikaeli
authors: Akram
authors: A
authors: Pourshams
authors: Ali
authors: A
authors: Ali-Asgari
authors: Reza
authors: R
authors: Malekzadeh
authors: Sadegh
authors: S
authors: Massarrat
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000382:microbiology*; D005260:Female; D005664:Furazolidone / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D013276:Stomach Ulcer / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D008795:Metronidazole; D005664:Furazolidone; D000658:Amoxicillin