Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease.
OBJECTIVE
To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole, bismuth subcitrate, furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.


METHODS
Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens. The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for 7 d. Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology). Safety was determined by the presence of adverse effects.


RESULTS
Fifty-one patients were enrolled. The eradication rate was 68.8% (31/45). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effects.


CONCLUSIONS
The association of bismuth, furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens. It is an effective, cheap and safe option for salvage therapy of positive patients.
Felga
Guilherme-Eduardo-Goncalves
GE
Department of Gastroenterology, University of Sao Paulo, Rua Dr. Eneas de Carvalho Aguiar, 255-Sala 9159, Sao Paulo 054003-000, Brazil.
Silva
Fernando-Marcuz
FM
Barbuti
Ricardo-Correa
RC
Navarro-Rodriguez
Tomas
T
Zaterka
Schlioma
S
Eisig
Jaime-Natan
JN
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005664:Furazolidone / Q000008:administration & dosage* / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage; D009942:Organometallic Compounds / Q000008:administration & dosage; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D012008:Recurrence; D016879:Salvage Therapy; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D005664:Furazolidone; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole