Hosseini Vahid, Mokhtare Marjan, Gholami Mohsen, Taghvaei Tarang, Maleki Iradj, Valizadeh Mohammad, Bari Zohreh, Fakheri Hafez
Inflammatory Diseases of the Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Middle East J Dig Dis. 2014 Oct;6(4):195-202.
BACKGROUND Furazolidone has been used as an alternative for clarithromycin or metronidazole in Helicobacterpylori (H.pylori) eradication regimens. In Iran, 14-day Furazolidone-containing quadruple regimens have shown promising eradication rates, but short-course, low dose therapies are always attractive. Therefore, we designed a study to compare the efficacy of two 10-day triple regimens containing moderate and high dose furazolidone for H.pylori eradication. METHODS Two hundred and ten patients with peptic ulcer disease who were naïve to H.pylori treatment were included. They were randomized into 2 groups: 105 patients received omeprazole 20mg, amoxicillin 1000mg, and furazolidone 200mg(OAF-400), all twice a day for ten days.And the remaining 105 patients received omeprazole 20mg twice a day, amoxicillin 1000mg twice a day and furazolidone 200mg three times a day for ten days(OAF-600). Urease breath test was performed 8 weeks after the treatment to confirm H. pylori eradication. RESULTS The intention-to-treat eradication rate was 76.19% in group OAF-400 and 80.95% in group OAF-600 (pp=0.38). Per protocol eradication rates were 81.63% and 89.47%, respectively (p= 0.11).Severe adverse effects were reported by 8.6% of the patients in group OAF-400 and 5.7% of the patient in group OAF-600 (p=0.1). However, the total side effects (including mild, moderate, and severe ones) were significantly more prevalent in the OAF-600 group (p=0.001). CONCLUSION None of our triple furazolidone-based regimens (moderate- and high-dose) could achieve the standard eradication rate, and therefore, cannot be considered as a suitable option for first-line treatment.
在幽门螺杆菌（H.pylori）根除方案中，呋喃唑酮已被用作克拉霉素或甲硝唑的替代药物。在伊朗，含呋喃唑酮的14天四联方案已显示出有前景的根除率，但短疗程、低剂量疗法一直很有吸引力。因此，我们设计了一项研究，比较两种含中等剂量和高剂量呋喃唑酮的10天三联方案对幽门螺杆菌根除的疗效。
纳入210例未接受过幽门螺杆菌治疗的消化性溃疡病患者。他们被随机分为2组：105例患者接受奥美拉唑20mg、阿莫西林1000mg和呋喃唑酮200mg（OAF-400），均每日2次，共10天。其余105例患者接受奥美拉唑20mg每日2次、阿莫西林1000mg每日2次和呋喃唑酮200mg每日3次，共10天（OAF-600）。治疗8周后进行尿素呼气试验以确认幽门螺杆菌根除情况。
OAF-400组意向性治疗根除率为76.19%，OAF-600组为80.95%（p = 0.38）。符合方案分析的根除率分别为81.63%和89.47%（p = 0.11）。OAF-400组8.6%的患者和OAF-600组5.7%的患者报告有严重不良反应（p = 0.1）。然而，OAF-600组的总副作用（包括轻度、中度和重度）明显更常见（p = 0.001）。
我们基于呋喃唑酮的三联方案（中等剂量和高剂量）均未达到标准根除率，因此，不能被视为一线治疗的合适选择。
