Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population

Malekzadeh, R. et al. (2003) Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population. Journal of Gastroenterology and Hepatology, 18(1), pp. 13-17. (doi: 10.1046/j.1440-1746.2003.02897.x)

Abstract

Background: In Iran, there is insufficient information on the efficacy of Helicobacter pylori eradication regimens shorter than 10 days. This study aims at assessing the efficacy of 4- and 7-day H. pylori eradication regimens in a high-incidence area of gastric cancer in Iran. Methods: Subjects with an endoscopic diagnosis of gastritis, positive urease test, and a histological diagnosis of chronic gastritis were enrolled. Patients were randomly assigned to one of three groups: AOC7 (1000 mg amoxicillin, 20 mg omeprazole, and 500 mg clarithromycin twice daily for 7 days), FOT4 (200 mg furazolidone, 20 mg omeprazole, and 500 mg tetracycline twice daily for 4 days) and FOT7 (the same treatment as the FOT4 group but for 7 days). Sensitivity to these antibiotics was determined in all isolates recovered from culture. The efficacy of eradication was assessed 8 weeks after the end-of-treatment by the 14C-urea breath test. Results: One hundred and twenty-eight patients were enrolled in the study. Culture was positive for 84 patients and none of these were resistant to amoxicillin, tetracycline or furazolidone, 1.2% were resistant to clarithromycin and 32.1% to metronidazole. Forty-five, 41 and 42 patients were randomly allocated to the AOC7, FOT4, and FOT7 groups, respectively. The intention-to-treat eradication rates were 35.5, 17.1, and 23.8% for the AOC7, FOT4, and FOT7 groups, respectively. Conclusion: Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Derakhshan, Professor Mohammad
• Authors: Malekzadeh, R., Merat, S., Derakhshan, M.H., Siavoshi, F., Yazdanbod, A., Mikaeli, J., Sotoudemanesh, R., Sotoudeh, M., Farahvash, M.J., Nasseri-Moghaddam, S., Pourshams, A., Dolatshahi, S., Abedi, B., Babaei, M., Arshi, S., and Majidpour, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Gastroenterology and Hepatology
• ISSN: 0815-9319
• Published Online: 20 December 2002