Document Detail


A comparison between sequential therapy and a modified bismuth-based quadruple therapy for Helicobacter pylori eradication in Iran: a randomized clinical trial.
MedLine Citation:
PMID:  22221615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sequential regimens have been recently reported to be superior to the standard triple therapies in Helicobacter pylori eradication, but most of these studies were performed in Europe and data from developing countries are lacking. So we designed a study to compare a sequential regimen with a bismuth-based quadruple therapy that contains a short course of furazolidone, in Iran.
METHODS: Two hundred and ninety-six patients with duodenal ulcer and naïve H. pylori infection were randomized into two groups: 148 patients received (PAB-F) pantoprazole (40mg-bid), amoxicillin (1g-bid), and bismuth subcitrate (240mg-bid) for 2weeks and furazolidone (200mg-bid) just during the first week. And 148 patients received (PA-CT) pantoprazole (40mg-bid) for 10days, amoxicillin (1g-bid) for the first 5days, and clarithromycin (500mg-bid) plus tinidazole (500mg-bid) just during the second 5days. C(14) -urea breath test was performed 8weeks after the treatment.
RESULTS: Two hundred and sixty-one patients completed the study (137 patients in the PA-CT and 124 in the PAB-F group). The results were not statistically different between the two groups in the eradication rates and the severity of side effects. The intention to treat eradication rate was 80.4% in the PAB-F group and 83.7% in the PA-CT group. Per-protocol eradication rates were 88.7% and 89.1%, respectively.
CONCLUSION: Because the two regimens showed acceptable and similar abilities in H. pylori eradication and because of much higher cost of clarithromycin in Iran, the furazolidone containing regimen seems to be superior. Further modifications of sequential therapies are needed to make them ideal regimens in developing countries.
Authors:
Hafez Fakheri; Tarang Taghvaei; Vahid Hosseini; Zohreh Bari
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Helicobacter     Volume:  17     ISSN:  1523-5378     ISO Abbreviation:  Helicobacter     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-09-28     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  9605411     Medline TA:  Helicobacter     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-8     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Gastroenterology, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran. fakher42@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use
Adult
Amoxicillin / therapeutic use
Anti-Bacterial Agents / therapeutic use*
Bismuth / administration & dosage,  therapeutic use*
Clarithromycin / therapeutic use
Drug Therapy, Combination
Duodenal Ulcer / drug therapy
Female
Furazolidone / therapeutic use
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects,  pathogenicity
Humans
Iran / epidemiology
Male
Middle Aged
Organometallic Compounds / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Bacterial Agents; 0/Organometallic Compounds; 26787-78-0/Amoxicillin; 67-45-8/Furazolidone; 7440-69-9/Bismuth; 81103-11-9/Clarithromycin; D8TST4O562/pantoprazole; HS813P8QPX/bismuth tripotassium dicitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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