title: Furazolidone, co-amoxiclav, colloidal bismuth subcitrate, and esomeprazole for patients who failed to eradicate Helicobacter pylori with triple therapy.
abstract: There is increasing evidence of Helicobacter pylori (H. pylori) resistance to the classical triple therapy consisting of a proton-pump inhibitor and clarithromycin with either amoxicillin or metronidazole. This study is aimed at establishing the efficacy and safety of a 14-day regimen to eradicate H. pylori in patients who have failed with the classical triple therapy given for 14 days. One hundred seventy-six patients diagnosed to have H. pylori infection were given triple therapy for 14 days. Fifty-two patients who failed to respond as evident from positive 14C-urea breath test (UBT) done 4-6 weeks after the completion of triple therapy were offered a combination regimen comprised of furazolidone 200 mg b.i.d, co-amoxiclav 1 g b.i.d., colloidal bismuth subcitrate 240 mg b.i.d., and esomeprazole 40 mg b.i.d. for 14 days. The mean age of these patients was 41 +/- 13 years (range 20-67). Thirty-four were males. To document eradication of H. pylori, UBT was repeated 4 weeks after the completion of treatment. On an intention-to-treat analysis, the eradication rate was 81% (42 out of 52) whereas on per-protocol basis, the eradication rate was 82.4% (42 out of 51). In conclusion, this new regimen represents a suitable second-line therapy.
authors.affiliation: Department of Medicine, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan. zaigham@akunet.org
authors.forename: Zaigham
authors.initials: Z
authors.lastname: Abbas
authors.forename: Javed
authors.initials: J
authors.lastname: Yakoob
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.forename: Zahid
authors.initials: Z
authors.lastname: Azam
authors.forename: Imran
authors.initials: I
authors.lastname: Hilal
mesh_terms: D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000009:adverse effects / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005664:Furazolidone / Q000009:adverse effects / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D005664:Furazolidone; D019980:Amoxicillin-Potassium Clavulanate Combination; C002791:bismuth tripotassium dicitrate; D064098:Esomeprazole