جستجوی مقالات مرتبط با کلیدواژه « furazolidone » در نشریات گروه « پزشکی »

For the first time, a new, simple, precise reversed-phase high-performance liquid chromatography method was developed for the simultaneous estimation of metronidazole, furazolidone, and dicyclomine hydrochloride in capsule dosage form. The method was performed with Thermo, C8 (150 mm×4.6) column. The best separation was achieved by gradient elution with mobile phase of acetonitrile, water (40:60), and 20 mm phosphate buffer with 10% w/v sodium hydroxide (pH 7.5) with a detection wavelength of 215 nm. The separation was completed within 15 min of runtime. The retention time of metronidazole, furazolidone, and dicyclomine hydrochloride was found to be 1.79, 2.45, and 11.50 min, respectively. The proposed method was found to be linear. The method was statistically validated as per the ICH guidelines and shown to be simple, accurate, precise, linear, and reproducible in the range of 40.2–60, 40.2–60.4, and 3–5 µg/mL for metronidazole, furazolidone, and dicyclomine, respectively. For the first time, the developed method foretells the suitability of the method for the simultaneous estimation of three drugs in the commercially available dosage forms.

This study aimed to analyze the cost-effectiveness of two routine therapeutic methods for H. pylori eradication in Iran

Because of the importance of Helicobacter pylori (H. pylori) eradication on gastric cancer prevalence and costs, an economic analysis of the eradication methods is essential for health systems.

This cross-sectional study was conducted on 7,496 participants with positive Hepadnaviridae (HPsAg) test results for H. pylori; 6,163 of them were treated with furazolidone (group A), and 1,333 participants were treated with clarithromycin (group B). Data on GP visits, medications, and HPsAg costs as direct costs and absence from work and transportation as indirect costs was collected by researcher-made questionnaire. Indirect costs were calculated based on face-to-face interviews with 365 patients of the Persian Cohort Center. Successful eradication of H. pylori infection (negative HPsAg) was defined as the effectiveness of the interventions. Incremental cost-effectiveness ratio (ICER) was used to compare the overall results.

The total direct cost of H. pylori for groups A and B were estimated at 13.7 and 5.83 billion IRR, respectively. The highest and lowest percentages of total costs were the cost of diagnostic services and the time cost, respectively. There was a significant difference between the two groups in drug costs (p<0.001). The effect ratio for groups A and B was 85.93% and 96.54%, respectively. Cost per effectiveness was higher for clarithromycin (CE=3,250,170 IRR) than for furazolidone (CE=2,988,488 IRR), and ICER showed that 5.1 Million IRR per participant is needed to eradicate H. pylori.

Based on the results, furazolidone was more cost-effective than clarithromycin for H. pylori treatment. Therefore, due to the high prevalence of H. pylori and the economic conditions of the health system in Iran, furazolidone can be a cost-effective choice between the two conventional treatment methods considering the results of further research and possible side effects.

Antibiotic resistance is a major cause of Helicobacter pylori (H. pylori) treatment failures. The increased resistance to clarithromycin and metronidazole has reduced the ability of this therapeutic regimen and prompted researchers to look for other drugs. One of the antibiotics of interest in this regard is furazolidone because of its low drug resistance. The aim of this study is compare two-drug regimens including low-dose and high-dose furazolidone in the treatment of H. pylori.

This study is a clinical trial in which the studied subjects were categorized into two groups. The first group underwent treatment with amoxicillin 1000 mg-BD, furazolidone 100 mg-BD, omeprazole 20 mg-BD, and bismuth subcitrate 240 mg- BD for two weeks (low-dose OFAB). The second group received furazolidone 200 mg-BD (high-dose OFAB). Then eight weeks after completion of the treatment, they were examined in terms of eradication via the UBT test.

85 participants completed the study in each group. The response to treatment was 76% and 83% in the low and high-dose groups, respectively, based on intention to treat analysis. Based on per protocol analysis the response to treatment was 78% and 84%, respectively, if excluded patients had completed their protocol and had response to treatment, and 72% and 79%, respectively, if excluded patients had completed their protocol and did not have response to treatment (p = 0.298). In the low-dose and high-dose groups, 16.5% and 24.7% of the participants suffered the complications of treatment with furazolidone (p = 0.18), respectively. Three patients in the high-dose group and one in the low-dose group did not complete the treatment because of the medication’s bad taste (p = 0.03).

Low doses of furazolidone had a comparable therapeutic effect compared with high doses, but patients experienced significantly lower levels of bad taste, which was a major cause of reluctance to continue treatment. Therefore, we think four-drug low-dose furazolidone treatment is a good choice in eradicating H. pylori.

Although the prevalence of Helicobacter pylori infection decreased following the hygiene promotion and application of proper anti- H.pylori treatments, unfortunately gradual increase is reported in treatment failure; hence, application of a proper treatment regimen as a second-line therapy is of great importance.
In the current randomized, clinical trial, a total of 120 patients with peptic ulcers who failed to respond to treatment were enrolled. In the OLA group, a regimen of omeprazole 40 mg/day, levofloxacin 1 g/day, and amoxicillin 2 g/ day was prescribed; however, a regimen of omeprazole 40 mg/day, bismuth sub-citrate 480 mg/day, furazolidone 400 mg/day, and amoxicillin 2 g/day was administered to the OFAB group. Both groups were treated for 2 weeks, and 6 weeks after the treatment, the urea breath test (UBT) was performed in the subjects. Collected data were analyzed with SPSS Version 18. At the end, 58 patients in group OLA and 57 patients in the OFAB group were analyzed.
According to the results of the current study, 96.7% of the subjects in the OLA and 95% in the OFAB groups completed the treatment course and the eradication rates were 86.7% and 78.3% in the OLA and OFAB groups, respectively (P=0.23). Treatment side effects were observed in 51.7% and 11.7% of the subjects in the OLA and OFAB groups, respectively (P<0.01).
Both regimens were applicable as the second-line therapy due to insignificant difference between the results of the 2 groups; however, OLA regimen was superior to OFAB, due to lower side effects.

Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of P

Several large clinical trials and meta-analyses have shown about 20% failure to eradicate Helicobacter pylori (H. pylori), necessitating investigations for second-line treatments. The aim of this study was to evaluate the effects of clarithromycin-containing quadruple regimen after nitroimidazole-containing quadruple therapy failure. Thirty two patients who had failed 10-day H. pylori treatment with omeprazole, amoxicillin, bismuth subcitrate, and metronidazole (OABM) regimen and 31 patients who had failed 10-day treatment with omeprazole, amoxicillin, bismuth subcitrate, and furazolidone (OAMF) regimen entered the study. They all received omeprazole (20 mg), amoxicillin (1 gr), bismuth subcitrate (240 mg) and clarithromycin (500 mg) twice a day for 10 days. Eight weeks after treatment, H. pylori eradication was assessed by ¹⁴C-urea breath test. Totally 61 patients completed the study. According to intention to treat (ITT) analysis, eradication rates by second-line OABC regimen were 84.37% (95% CI= 71.7–96.9%) in OABM group and 77.41% (95% CI= 62.71–92.11%) in OABF group (P=0.756). Per-protocol (pp) eradication rates were 87.09% (95% CI= 75.2–98.8%) and 82.75% (95% CI= 79.4–96%), respectively (P=0.638). Also the cumulative eradication rates by OABC regimen were 80.9% (95% CI= 71.2–90.6%) and 85% (95% CI= 75.9–94%) according to ITT and PP analyses, respectively. Severe side effects were reported in 3.1% of the patients.Regarding ideal eradication rate (>80%) and very low adverse effects, it seems that clarithromycin-containing quadruple therapy can be an encouraging regimen after nitroimidazole-containing regimen failure.

Helicobacter pylori infections occur in about 50% of the world population and have a main role in the creation of peptic ulcer and its related cancer. We sought to evaluate the effectiveness of two treatment regimens on the eradication of helicobacter pylori and its complications among peptic ulcer patients.

By a clinical trial, patients with peptic ulcer showing an infection compliance of more than 80%, confirmed by biopsy, were entered into the study and were randomly divided in two groups. Group A was treated by medical regimen of Amoxicilline, Bismot, Omeperasol and Furazolidone (ABOF) and group B by medical regimen of Amoxicilline, Bismot, Omeperasol and Clarithromycin (ABOC) for two weeks. In the next step, both groups were treated by only Omeperasol for two weeks and finally, the infection rate of h. pylori was investigated by urea breath testing among both groups.

Among the 137 registered patients, 17 were unable to continue. The mean age of patients in group A, was 36.1 years and for group B, was 40.1 years. The rate of infection eradication in group A was 38.3% and in group B was 53.3% (P= 0.07). The most common symptoms among patients in group A were a bad taste mouth (80%) and headache (70%) and in the group B including headache (62%) and a bad taste mouth (60%) respectively.

ABOF regimen compared to ABOC, showed a lower rate of infection eradication and also more complications for patients and the ABOC was considered as the preferred regimen.

The eradication of Helicobacter pylori infection, commonly prevailing in the stomach, has been important since its introduction. Adequate preparations should be made in finding alternatives when faced with first-line treatment failures. Currently, ideal second-line treatments are indistinct and varied among countries as result of different antibiotic resistance patterns. We aimed to evaluate the safety and efficacy of a clarithromycin-containing bismuth-based quadruple regimen as a second-line treatment.Forty-eight H. pylori-positive patients with proven gastric or duodenal ulcers and/or erosions who had previously failed to respond to furazolidone-containing regimens were enrolled. They received pantoprazole (40 mg-bid), amoxicillin (1 g-bid), bismuth subcitrate (240 mg-bid), and clarithromycin (500mg-bid) for 10 days. Eight weeks after treatment, a 14C-urea breath test was performed for the re-evaluation of H. pylori eradication. Forty-three patients completed the study. H.pylori eradication rates were 79.2% (95% CI=65.00-89.53) and 88.4% (95% CI=74.91-96.11) according to intention-to-treat and per-protocol analyses, respectively. All patients had excellent compliance to treatment and one did not continue therapy because of adverse effects. In developing countries such as Iran, a ten-day clarithromycin-containing bismuth-based quadruple regimen is encouraged as a second-line treatment because of the acceptable rate of eradication and low adverse effects.

The effectiveness of classic standard triple therapy regimen of helicobacter pylori (H. pylori) eradication has decreased to unacceptably low levels, largely related to development of resistance to metronidazole and clarithromycin. Thus successful eradication of H. pylori infections remains challenging. Therefore alternative treatments with superior effectiveness and safety should be designed and appropriately tested in all areas depending on the native resistance patterns. Furazolidone has been used successfully in eradication regimens previously and regimens containing furazolidone may be an ideal regimen. H. pylori infected patients with proven gastric or duodenal ulcers and /or gastric or duodenal erosions at Imam Khomeini Hospital in Sari/Northern Iran, were randomly allocated into three groups: group A (OABF) with furazolidone (F) (200 mg bid.), group B (OABM-F) metronidazole (M) (500 mg bid.) for the first five days, followed by furazolidone (F) (200 mg bid.) for the second five days and group C (OAF) with furazolidone (F) (200 mg tid.). Omeprazole (O) (20 mg bid.) and amoxicillin (A) (1000 mg bid.) were given in all groups; bismuth (B) (240 mg bid.) was prescribed in groups A & B. Duration of all eradication regimens were ten days. Eight weeks after treatment, a 14C-urea breath test was performed for evaluation of H. pylori eradication. A total of 372 patients were enrolled in three groups randomly (124 patients in each group); 120 (97%) patients in group A (OABF), 120 (97%) in group B (OABM-F) and 116 (93%) in group C (OAF) completed the study. The intention-to-treat eradication rates were 83.7% (95% CI= 77.3–90.4), 79.8% (95% CI=72.6–87), and 84.6% (95% CI= 78.2–91.1) and per-protocol eradication rates were 86.6% (95% CI= 80.5–92.8), 82.5% (95% CI= 75.6–89.4), and 90.5% (95% CI= 85.1–95.9) for groups OABF, OABM-F, and OAF, respectively. No statistical significant differences were found in case of severe drug adverse effects between the above mentioned three groups (p>0.05). The most common side effects, namely nausea and fever, occurred in all groups, but more frequently in group C (OAF) (p<0.05). In developing countries such as Iran, furazolidone-based regimens can substitute clarithromycin-based regimens for H. pylori eradication because of a very low level of resistance, low cost and high effectiveness. Considering per-protocol eradication rate of ten days OAF regimen, and the acceptable limit of ninety percent, we recommend this regimen in developing countries such as Iran to be substituted of classic standard triple therapy. In order to minimize rare serious adverse effects, one week high dose OAF regimen should be taken into consideration in other studies.

Helicobacter pylori is the main pathogenic factor for chronic gastritis and peptic ulcer disease. Therefore, its successful eradication is important in the disease management. Multiple first-line treatments have been employed; the eradication rates in the most successful regimens have been 75%-92%. Primary bacterial resistance to antibiotics and patient compliance are two main cause of therapy failure. Furazolidone with a broad spectrum of antimicrobial activities is widely used in the treatment of bacterial and protozoal infections in both humans and animals, which could also be used in treatment of H. pylori infection.. This study was designed to evaluate the efficacy of the therapeutic regimen containing furazolidone in comparison with a standard regimen against H. pylori.. In this randomized clinical trial, 110 patients with a positive urease breath test (UBT) were selected and randomly divided into two equal groups. The first group received the standard regimen consisting of clarithromycin (500 mg Q12h), amoxicillin (1 g Q12) and a proton pump inhibitor (PPI) (omeprazole 20 mg BID). The second group received bismuth subcitrate (120 mg Q6h), furazolidone (100 mg Q6h) and tetracycline (250 mg Q6h) and a PPI (omeprazole 20 mg BID) for two weeks. UBT was performed again for all the patients two months after completing.. UBT was negative in 83.6% of patients in the standard group two months after the end of the treatment. Eradication of H. pylori was reported in 94.5% of patients in the experimental group. No significant relationship between age and eradication of H. pylori was observed in both groups. Nausea and vomiting was reported in 5.45% of patients treated with our experimental regimen. These symptoms were tolerable and the treatment was completely continued. No adverse effect was recorded in the standard group. Moreover, no relationship was observed between gender and eradication of H. pylori in both groups. Finally, despite a better therapeutic response to our experimental group in comparison with the standard one, no statistically significant difference was observed (P = 0.067).. Based on our finding in this study and similar studies in different parts of the world, furazolidone could be prescribed as an effective antibiotic against H. pylori in patients with gastritis..

To comparing furazolidone and tetracycline in quadruple therapy for eradication of helicobacter pylori in dyspepsia patients. Helicobacter pylori eradication is the main step in dyspepsia and peptic ulcer management. In Iran different regimens have been proposed, however, most of our patients are resistant to metronidazole. In the current study we compared furazolidone- and tetracycline-based quadruple therapy for eradication of H.pylori in a group of Iranian patients with dyspepsia.Patients and Dyspeptic patients were randomly assigned in 2 groups and received omeprazole 20mg/twice a day, bismuth subcitrate 200mg/q6h, amoxicillin 1000mg/twice a day in association with furazolidone 100mg/ twice a day (OAB-F regimen) or tetracycline 500mg/ twice a day (OAB-T regimen). Stool antigen test was used to detect H. pylori eradication. Totally, 100 patients completed the desired regimen including 49 in OAB-F and 51 in OAB-T regimen. Following the first week, H. pylori was eradicated in 97.9% of OAB-F and 96% of OAB-T subjects, however, the difference did not reach a statistical significant level. These figures were 85.7% and 80.4% following the 4th week, respectively (NS). Both furazolidone-and tetracycline-based quadruple therapy were revealed to be effective for eradication of H.pylori, however, furazolidone is suggested for population resistant to metronidazole since it is cheaper and more available.