Furazolidone, tetracycline and omeprazole: a low-cost alternative for Helicobacter pylori eradication in children

• Published in: Jornal de pediatria 2008-03, Vol.84 (2), p.160-165
• Main Authors: Machado, Rodrigo Strehl, Silva, Marcello Ruiz da, Viriato, Aírton
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - economics; Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - economics; Anti-Ulcer Agents - therapeutic use; Child; Drug Therapy, Combination; Female; Furazolidone - economics; Furazolidone - therapeutic use; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - microbiology; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Male; Omeprazole - economics; Omeprazole - therapeutic use; Prospective Studies; Tetracycline - economics; Tetracycline - therapeutic use; Treatment Outcome
• ISSN: 0021-7557
• DOI: 10.2223/JPED.1772

To evaluate furazolidone, tetracycline and omeprazole as first line therapy for Helicobacter pylori in children with digestive symptoms. Prospective and consecutive open trial. The study included patients older than 8 years old with functional dyspepsia, functional abdominal pain, severe histological abnormalities (intestinal metaplasia, gastric atrophy or mucosa-associated lymphoid tissue lymphoma) or peptic ulcer. H. pylori status was defined based both upon histology and rapid urease test. Drug regimen was a 7-day course of omeprazol, tetracycline (or doxycycline) and furazolidone twice daily. Eradication was assessed by upper endoscopy 2 months after treatment (histology and rapid urease test). Further clinical evaluation was done 7 days and 2 months after treatment. Thirty-six patients (21 female/15 male) were included. Age ranged from 8 to 19 years (mean 12.94+/-2.89 years). On intention-to-treat analysis (n = 36), eradication rate was 83.3% (95%CI 77.1-89.5) whereas in per-protocol analysis (n = 29), it was 89.7% (95%CI 84.6-94.7). Compliance was better when doxycycline was used, but the success rates were similar for the two tetracyclines. There was no variable associated with treatment failure. Side effects were reported in 17 patients (47.2%), mainly abdominal pain (11/30.5%), nausea (seven/19.4%) and vomiting (five/13.9%). Triple therapy with furazolidone and tetracycline is a low-cost alternative regimen to treat H. pylori infection.