Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2008; 14(40): 6224-6227
Published online Oct 28, 2008. doi: 10.3748/wjg.14.6224
Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease
Guilherme Eduardo Gonçalves Felga, Fernando Marcuz Silva, Ricardo Correa Barbuti, Tomás Navarro-Rodriguez, Schlioma Zaterka, Jaime Natan Eisig
Guilherme Eduardo Gonçalves Felga, Fernando Marcuz Silva, Ricardo Correa Barbuti, Tomás Navarro-Rodriguez, Schlioma Zaterka, Jaime Natan Eisig, Department of Gastroenterology, University of São Paulo, School of Medicine, São Paulo 054003-000, Brazil
Author contributions: Eisig JN designed this work; Barbuti RC, Navarro-Rodriguez T and Zaterka S made substantial contributions to the conception of the study; Silva FM and Barbuti RC performed the acquisition of data and quality control; Silva FM, Felga GEG and Eisig JN performed the statistical analysis and interpretation of data; Felga GEG and Eisig JN prepared and submitted the manuscript; All authors read and approved the final manuscript.
Correspondence to: Jaime Natan Eisig, MD, PhD, Department of Gastroenterology, University of São Paulo, Rua Dr. Enéas de Carvalho Aguiar, 255-Sala 9159, São Paulo 054003-000, Brazil. eisig@uol.com.br
Telephone: +55-11-30696447 Fax: +55-11-30697830
Received: February 2, 2008
Revised: July 19, 2008
Accepted: July 26, 2008
Published online: October 28, 2008
Abstract

AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole, bismuth subcitrate, furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.

METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens. The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for 7 d. Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology). Safety was determined by the presence of adverse effects.

RESULTS: Fifty-one patients were enrolled. The eradication rate was 68.8% (31/45). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effects.

CONCLUSION: The association of bismuth, furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens. It is an effective, cheap and safe option for salvage therapy of positive patients.

Keywords: Gastric ulcer, Duodenal ulcer, Helicobacter pylori, Retreatment, Furazolidone