Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Department of Biochemistry and Molecular Biology, Jiangxi Academy of Medical Science, Jiangxi, China.
Helicobacter. 2018 Apr;23(2):e12468. doi: 10.1111/hel.12468. Epub 2018 Feb 26.
Antibiotic resistance is a major cause of Helicobacter pylori (H. pylori) treatment failures. Because the resistance rate of H. pylori to furazolidone is low, we aimed to assess the efficacy and safety of furazolidone. We searched the PubMed, Web of Science, Cochrane Library, and Embase databases and included randomized controlled trials (RCT) that either compared furazolidone to other antibiotics or changed the administered dose of furazolidone. A total of 18 articles were included in the meta-analysis. According to the intention-to-treat (ITT) analysis, the total eradication rates of furazolidone-containing therapy were superior to those of other antibiotic-containing therapies (relative risk [RR] 1.07, 95% confidence interval [CI] 1.01-1.14) (13 RCTs). Specifically, the eradication rates of furazolidone-containing therapy were better than those for metronidazole-containing therapy (RR 1.10, 95% CI: 1.01-1.21 for ITT). The eradication rate of furazolidone-containing bismuth-containing quadruple therapy was 92.9% (95% CI: 90.7%-95.1%) (PP). In addition, a higher daily dose of furazolidone increased the eradication rate (RR 1.17, 95% CI: 1.05-1.31). And the incidence of some adverse effects, such as fever and anorexia, was higher in the furazolidone group than in the control group, the overall incidences of total side effects and severe side effects showed no significant differences between the groups. Furazolidone-containing treatments could achieve satisfactory eradication rates and did not increase the incidence of total or severe adverse effects, but the incidence of milder side effects, such as fever and anorexia, should be considered when prescribing furazolidone-containing treatments to patients.
抗生素耐药性是幽门螺杆菌 (H. pylori) 治疗失败的主要原因。由于 H. pylori 对呋喃唑酮的耐药率较低，我们旨在评估呋喃唑酮的疗效和安全性。我们检索了 PubMed、Web of Science、Cochrane Library 和 Embase 数据库，并纳入了比较呋喃唑酮与其他抗生素或改变呋喃唑酮给药剂量的随机对照试验 (RCT)。共有 18 篇文章纳入荟萃分析。根据意向治疗 (ITT) 分析，含呋喃唑酮治疗的总根除率优于其他含抗生素治疗 (相对风险 [RR] 1.07，95%置信区间 [CI] 1.01-1.14)(13 项 RCT)。具体而言，含呋喃唑酮治疗的根除率优于含甲硝唑治疗 (RR 1.10，95% CI：ITT 为 1.01-1.21)。含呋喃唑酮铋四联疗法的根除率为 92.9%(95%CI：90.7%-95.1%)(PP)。此外，呋喃唑酮的日剂量较高可提高根除率 (RR 1.17，95%CI：1.05-1.31)。并且，呋喃唑酮组的一些不良反应(如发热和厌食)的发生率高于对照组，两组总不良反应和严重不良反应的总发生率无显著差异。含呋喃唑酮的治疗可达到令人满意的根除率，并且不会增加总或严重不良反应的发生率，但在给患者开具含呋喃唑酮的治疗方案时，应考虑轻度副作用(如发热和厌食)的发生率。
