title: A modified bismuth-containing quadruple therapy including a short course of furazolidone for Helicobacter pylori eradication after sequential therapy failure.
abstract: BACKGROUND
  Helicobacter pylori eradication has still remained a challenge, especially in case of failure to novel treatments. Therefore, we designed a study to evaluate the effects of a modified bismuth-containing quadruple therapy including a short course of furazolidone on a group of patients whose sequential therapy had been unsuccessful.
  
  
  METHODS
  Thirty-six H. pylori-positive patients who had previously failed a clarithromycin-containing sequential therapy enrolled the study. They received pantoprazole (40 mg-bid), amoxicillin (1 g-bid), and bismuth subcitrate (240 mg-bid) for 2 weeks and furazolidone (200 mg-bid) just during the first week. Eight weeks after treatment, H. pylori eradication was reassessed using C14-urea breath test.
  
  
  RESULTS
  Thirty five patients completed the study. H. pylori eradication rates were 80.6% (95% CI = 67.6-93.5) and 82.9% (95% CI = 70.6-95.2) according to intention-to-treat and per-protocol analyses, respectively. All patients had excellent compliance to treatment, and no one interrupted therapy owing to adverse effects.
  
  
  CONCLUSIONS
  Regarding the eradication rate (>80%), low price, and very low adverse effects, a 2-week bismuth-containing quadruple regimen including a short course of furazolidone can be an encouraging regimen for second-line H. pylori eradication in case of sequential therapy failure. Possibly, it can be improved by alterations in dose, dosing intervals, and/or duration.
authors: Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors: Hafez
authors: H
authors: Fakheri
authors: Zohreh
authors: Z
authors: Bari
authors: Hossein
authors: H
authors: Sardarian
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005664:Furazolidone / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D005664:Furazolidone; D000658:Amoxicillin; D000077402:Pantoprazole; D001729:Bismuth