Furazolidone-based triple therapy for H pylori gastritis in children

AIM： To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastdtis. METHODS： A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive ^13C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone （100 mg, 200 mg if over 30 kg） twice daily. Eradication of H pylori was assessed two months after treatment by histology and ^13C-urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS： Thirty-eight patients （24 females, 14 males） were included. Their age ranged from 4 to 17.8 （mean 10.9 ± 3.7） years. On intent-to-treat analysis （n = 38）, the eradication rate of H pylori was 73.7% （95% CI, 65.2%-82%） whereas in per-protocol analysis （n = 33） it was 84.8% （95% CI, 78.5%-91%）. All the patients with duodenal ulcer （n = 7） were successfully treated （100% vs 56.2% with antral nodularity）. Side effects were reported in 26 patients （68.4%）, mainly vomiting （14/26） and abdominal pain （n = 13）. Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of Hpylori-positive patients after six months of treatment. CONCLUSION： Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.