Since the discovery of the etiological role of Helicobacter pylori (H pylori) in peptic ulcer disease, its eradication became the main objective of therapy, and several treatment regimens were developed. Currently, triple therapy with omeprazole, amoxicillin, and clarithromycin remains the best therapeutic option. Despite its efficacy, 10% to 20% of the patients present with treatment failure, demanding alternative therapeutic regimes with variable success rates. The development of effective salvage treatments is of paramount importance in this situation.
The research team led by Jaime Natan Eisig, from Brazil addresses this question and this will be be published on October 28; 2008 in the World Journal of Gastroenterology.
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 seven days. Patients were considered as eradicated when samples taken from the gastric antrum and corpus twelve weeks the end of treatment were negative for H pylori (rapid urease test and histology). Safety was determined by the adverse effects.
In this study, 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 effect. Their result indicated that the association of bismuth, furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for peptic ulcer patients.
Reference: Felga GEG, Silva FM, Barbuti RC, Navarro-Rodriguez T, Zaterka S, Eisig JN. Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease. World J Gastroenterol 2008; 14(40): 6224-6227 http://www.wjgnet.com/1007-9327/14/6224.asp
Correspondence to: Jaime Natan Eisig, MD, PhD, Department of Gastroenterology, University of São Paulo, Rua Dr. Enéas de Carvalho Aguiar, 255-Sala 9159, São Paulo 054003-000, Brazil. eisig@uol.com.br Telephone: +55-11-30696447 Fax: +55-11-30697830
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology