Objective: To explore the eradication efficacies of triple versus quadruple furazolidone-based regimens for Helicobacter pylori (H. pylori) infection.
Methods: A total of 357 outpatients with H. pylori infection were enrolled from June to December 2010. There were 200 males and 157 females with an average age of (42 ± 12) years. A diagnosis of duodenal ulcer was made according to their endoscopic examination results. They were randomly assigned into 4 treatment groups: 7-day triple (n = 89) and 10-day triple (n = 91), rabeprazole 10 mg, amoxicillin 1 000 mg and furazolidone 100 mg twice daily for 7 and 10 days respectively. 7-day quadruple (n = 88) and 10-day quadruple (n = 89), rabeprazole 10 mg, bismuth 220 mg, amoxicillin 1 000 mg and furazolidone 100 mg twice daily for 7 and 10 days respectively.H. pylori status was re-assessed with (14)C-urea breath test after 4-week therapy.
Results: Among them, 323 cases completed the study. According to the analysis of intention-to-treat (ITT), the H. pylori eradication rates were 71.91% (64/89) in 7-day triple, 81.32% (74/91) in 10-day triple, 78.41% (69/88) in 7-day quadruple and 83.15% (74/89) in 10-day quadruple groups. No significant deviation existed among all groups (P > 0.05). According the per-protocol (PP) analysis, H. pylori eradication rates were 78.05% (64/82) in 7-day triple, 88.10% (74/84) in 10-day triple, 87.34% (69/79) in 7-day quadruple and 94.87% (74/78) in 10-day quadruple groups. Significant deviation existed among all groups (P = 0.017). The H. pylori eradication rate in 10-day quadruple group was significantly higher than that in 7-day triple group (P = 0.002). The total adverse reaction rate was 7.00% (25/357). No significant difference existed among all groups (P > 0.05).
Conclusions: Quadruple treatments provide higher H. pylori eradication rates than triple therapies. A 10-day treatment may improve H. pylori eradication rate. And 10-day quadruple regimen with furazolidone and bismuth may be effective for H. pylori infection.