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World J Gastroenterol. Sep 14, 2006; 12(34): 5544-5549
Published online Sep 14, 2006. doi: 10.3748/wjg.v12.i34.5544
Furazolidone-based triple therapy for H pylori gastritis in children
Elisabete Kawakami, Rodrigo Strehl Machado, Silvio Kazuo Ogata, Marini Langner, Erika Fukushima, Anna Paula Carelli, Vania Cláudia Guimarães Bonucci, Francy Reis Silva Patrício
Elisabete Kawakami, Rodrigo Strehl Machado, Silvio Kazuo Ogata, Marini Langner, Erika Fukushima, Anna Paula Carelli, Vania Cláudia Guimarães Bonucci, Peptic Diseases Outpatient Clinic, Pediatric Gastroenterology Division, Department of Pediatric, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, SP, Brazil
Francy Reis Silva Patrício, Department of Pathology, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, SP, Brazil
Correspondence to: Rodrigo Strehl Machado, 441 Pedro de Toledo Street, Sao Paulo 04041-039, Brazil. rodrigo@gastroped.epm.br
Telephone: +55-11-55794351 Fax: +55-11-55795834
Received: February 15, 2006
Revised: February 28, 2006
Accepted: April 21, 2006
Published online: September 14, 2006
Abstract

AIM: To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis.

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 H pylori-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.

Keywords: Furazolidone; H pylori treatment; Gastritis; Children