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

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...

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Published in:Journal of gastroenterology and hepatology 2003-01, Vol.18 (1), p.13-17
Main Authors: MALEKZADEH, REZA, MERAT, SHAHIN, DERAKHSHAN, MOHAMMAD-HASSAN, SIAVOSHI, FARIDEH, YAZDANBOD, ABBAS, MIKAELI, JAVAD, SOTOUDEMANESH, RASOUL, SOTOUDEH, MASOUD, FARAHVASH, MOHAMMAD-JAFAR, NASSERI-MOGHADDAM, SIAVOSH, POURSHAMS, AKRAM, DOLATSHAHI, SHAHAB, ABEDI, BEHNOOSH, BABAEI, MASOUD, ARSHI, SHAHNAM, MAJIDPOUR, ALI
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - administration & dosage
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Biological and medical sciences
Drug Administration Schedule
Drug Combinations
Female
Helicobacter Infections - drug therapy
Helicobacter pylori
Human bacterial diseases
Humans
Infectious diseases
Iran
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
therapeutics
Treatment Outcome
Tropical medicine
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Summary: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. © 2003 Blackwell Publishing Asia Pty Ltd
ISSN:0815-9319
1440-1746
DOI:10.1046/j.1440-1746.2003.02897.x