H pylori infection was associated with many upper gastrointestinal diseases. The prevalence of H pylori resistant to antibiotics was increased with the spreading of H pylori eradication. Many patients needed receive rescue therapy for the eradication of H pylori after first- or second-line therapies. Furazolidone has been used for the eradication of H pylori for many years, but to use it as a component of quadruple rescue therapy has been reported less frequently. Whether a quadruple therapy will lead to a better success rate for rescue treatment of H pylori infection.
A research article to be published on February 21, 2009 in the World Journal of Gastroenterology addresses this question. This research lead by Professor Hu and Dr. Cheng from Peking University First Hospital used different components of furazolidone, amoxicillin, bismuth and rebaprazole as rescue therapy for H pylori retreatment. 60 patients who had failed to respond to at least one treatment course were randomized to three arms where medication was given for one week, two weeks or for two weeks with an increased dose of furazolidone. ITT eradication rates ranged from 70-90% with no significant difference.
Furazolidone-based regimens for the eradication of H pylori are low cost. Several studies have shown the efficacy of regimens containing a high-dose furazolidone (200 mg, b.i.d.) as the therapy in patients with H pylori infection. Side effects from furazolidone are the main disadvantage of this drug. Lower doses of furazolidone could decrease the incidence of adverse events. Not many studies have been performed to evaluate the efficacy of low dose (100mg, b.i.d.) furazolidone-based regimens for retreatment of H pylori infection. This study provides further evidence of the efficacy and tolerability of different low dose furazolidone-based quadruple regimens in China, and the results were highly successful.
Low dose furazolidone-based quadruple regimens may be useful rescue therapies for H.pylori eradication due to their low cost, low resistance rate and relatively minor side effects, especially in developing countries such as China. The results may depend on the area and the sensitivity of the prevalent strain of H pylori to Furazolidine.
Furazolidone has been used for the eradication of H pylori for many years but here it has been used as a component of quadruple rescue therapy. This has been reported less frequently. The study suggests that in the population studied eradication rates were good taking account of the fact that all patients had failed to respond to at least one previous treatment regimen. Side effects from furazolidone are the main disadvantage of this drug, but when used in a small dose as in this study side effects were relatively minor. The further study should be down to conclude whether the increased dose of furazolidone or the longer period of treatment is helpful
Reference: Cheng H, Hu FL. Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori. World J Gastroenterol 2009; 15(7): 860-864
http://www.wjgnet.com/1007-9327/15/860
Correspondence to: Hong Cheng, Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China. chenghong@medmial.com.cn
Telephone: +86-10-66551122-2581 Fax: +86-10-66518105
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