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The effectiveness of the 7-day course of furazolidone, levofloxacin and lansoprazole after the ineffectiveness of the standard eradication course Helicobacter pylori

The main reason for the ineffective eradication of Helicobacter pylori is the increased resistance of Helicobacter to clarithromycin and nitroimidosols. There is currently no ideal second-line regimen, particularly in developing countries where the incidence of H. i is high. pylori, with a high prevalence of Helicobacter pylori resistance to antibiotics.

The purpose of a Brazilian study was to assess the efficacy, compliance and incidence of adverse events with triple therapy with furazolidone, levofloxacin and lansoprazole in patients with persistent infection caused by H. pylori, in which at least one previous course of Helicobacter eradication was ineffective.

The study included 48 patients with gastric ulcer and 12 duodenal ulcers. H. Pylori infection, was confirmed using a rapid urease test and a histological examination of mucous samples from different sections of the stomach obtained during the FGDS.

The eradication treatment included the appointment of 2 times a day inside lansoprazole 30 mg, furazolidone 200 mg and levofloxacin 250 mg for 7 days. The therapeutic efficacy of the treatment was confirmed by a negative rapid urease test, a histological examination and a respiratory urease test with a carbon atom marked C14, and all the examinations were carried out 12 weeks after the end of the treatment..

It turned out that only one in 48 patients was unable to take all of the medication due to the occurrence of an adverse event (vomiting). The eradication rate in the analysis according to the protocol (per-protocol analysis) was 89% (95% confidence interval 98-99%), and in the analysis according to the planned intervention (intentional analysis to treat - ITT) - 88% (95% CI 88-92%).

Mild to moderate adverse drug reactions were reported in 41 patients (85%). In patients who were ineffective from a single previous eradication treatment, the eradication rate was 100%. H. pylori eradication frequency was lower in patients who had previously failed one or more eradication regimens, including furazolidone (74% vs 100% , p = 0.002).

Thus, the study showed the great effectiveness of the three-component regimen levofloxacin + furazolidone + lansoprazole in eradicating H. pylori, in particular in patients presenting the ineffectiveness of a single previous treatment. anti-Helicobacter pylori.