Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Pharmacy, Marine Police Hospital, Jiaxing, China.
PLoS One. 2022 Apr 8;17(4):e0266763. doi: 10.1371/journal.pone.0266763. eCollection 2022.
Furazolidone is a synthetic nitrofuran with a broad spectrum of antimicrobial action and has been widely used in the treatment of Helicobacter pylori (H. pylori) infection. However, its safety profile has not been clarified. Moreover, the drug fever associated with its use is frequently misdiagnosed. The aim of this study was to explore the risk factors of furazolidone-associated fever to increase awareness and stimulate further research on this topic.
This was a retrospective case-control study of patients referred to a specialist clinic for furazolidone-containing quadruple regimens for H. pylori infection at a tertiary care hospital located in Eastern China between July 2018 and September 2018. We evaluated adult patients who received furazolidone treatment for Helicobacter pylori infection. The exclusion criteria were as follows: (1) patients were pregnant or breastfeeding; (2) patients received furazolidone treatment not for Helicobacter pylori infection; (3) patients had taken antibiotics or any acid suppressant or non-steroidal anti-inflammatory drug in the last 4 weeks; (4) patients had chronic hepatic, renal, or pulmonary disease. Pertinent information was retrieved from medical records and telephone follow-up. All statistical analysis was performed in SPSS version 22.0.
A total of 1499 patients received furazolidone and met the overall inclusion criterion. Of these 1499 patients, 27 (1.80%) developed drug fever. The mean time between initiation of furazolidone and the onset of fever is 11.00 ± 1.84 days, and the median peak fever was 38.87 ± 0.57°C. We found no differences in age and past drug allergy between the non-fever and fever groups. Through multiple logistic regression analysis, we found two variables as independent risk factors for furazolidone-associated fever, including gender (OR, 3.16; 95% CI, 1.26-7.91; P = 0.014) and clarithromycin (OR, 4.83; 95% CI, 2.17-10.79; P<0.001).
This retrospective cohort study identified two risk factors for furazolidone-associated fever, which were female and clarithromycin. We also analyzed the characteristics of drug fever during anti-Helicobacter pylori therapy. However, the underlying mechanisms are uncertain and require further research.
呋喃唑酮是一种具有广谱抗菌作用的合成硝基呋喃类药物，已广泛用于治疗幽门螺杆菌（H. pylori）感染。然而，其安全性尚未明确。此外，与该药相关的药物热常被误诊。本研究旨在探讨呋喃唑酮相关发热的危险因素，以提高认识并激发对此课题的进一步研究。
这是一项在中国东部一家三级医院的专科诊所进行的回顾性病例对照研究，研究对象为 2018 年 7 月至 9 月期间因幽门螺杆菌感染接受含呋喃唑酮的四联疗法的患者。我们评估了接受呋喃唑酮治疗幽门螺杆菌感染的成年患者。排除标准如下：（1）患者妊娠或哺乳期；（2）患者接受呋喃唑酮治疗并非用于幽门螺杆菌感染；（3）患者在过去 4 周内服用过抗生素或任何酸抑制剂或非甾体抗炎药；（4）患者患有慢性肝、肾或肺疾病。所有相关信息均从病历和电话随访中获取。所有统计分析均在 SPSS 22.0 版本中进行。
共有 1499 例患者接受了呋喃唑酮治疗，符合总体纳入标准。其中 27 例（1.80%）发生药物热。从开始使用呋喃唑酮到发热的平均时间为 11.00±1.84 天，中位峰值发热为 38.87±0.57°C。我们发现发热组和非发热组在年龄和既往药物过敏方面无差异。通过多因素逻辑回归分析，我们发现两个变量是呋喃唑酮相关发热的独立危险因素，包括性别（OR，3.16；95%CI，1.26-7.91；P=0.014）和克拉霉素（OR，4.83；95%CI，2.17-10.79；P<0.001）。
本回顾性队列研究确定了呋喃唑酮相关发热的两个危险因素，即女性和克拉霉素。我们还分析了抗幽门螺杆菌治疗期间药物热的特征。然而，其潜在机制尚不确定，需要进一步研究。
