Comparison of Clarithromycin-based Triple Therapy and Furazolidone-based Quadruple Therapy in Eradicating Helicobacter pylori Infection

Background: Helicobacter pylori infection is the most common infection of human. This organism is responsible for the majority of peptic ulcer diseases, MALToma and gastric cancer, worldwide. Several regimen therapies against H. pylori had developed and are prescribed empirically, but therapies have rarely been optimized. Objectives: In this study, we compared two regimens that are widely used in Iran, triple regimen (clarithromycin, amoxicillin, and omeprazole) and furazolidone-based quadruple regimen (furazolidone, amoxicillin, bismuth, and omeprazole) in some dyspeptic patients. Methods: In this cross-sectional study, 373 consecutive dyspeptic patients that H. pylori infection was established, randomized into one of the following groups; 188 in group A (treated with clarithromycin 500 mg, amoxicillin 1,000 mg, and omeprazole 20 mg twice daily for 10 days) and 185 in group B (furazolidone 200 mg, amoxicillin 1000 mg, bismuth subcitrate 240 mg and omeprazole 20 mg twice daily for 14 days). One month after discontinuation of the treatment, H. pylori eradication was evaluated with UBT. Results: Mean age of the patients was 35.9 ± 12.3 years, and the male to female ratio was 1: 1.6. In the per-protocol analysis, the eradication rate of H. pylori was 63.7% in comparison to 93% in group A and B, respectively (P < 0.004). Conclusions: Our study showed furazolidone-based quadruple regimen is superior to the standard triple regimen; thus, it is recommended as the first choice.