An ideal therapy for peptic ulcer disease

Since the discovery of the etiological role of Helicobacter pylori (H pylori) in peptic ulcer disease, its eradication became the main objective of therapy, and several treatment regimens were developed.

Currently, triple therapy with omeprazole, amoxicillin, and clarithromycin remains the best therapeutic option. Despite its efficacy, 10% to 20% of the patients present with treatment failure, demanding alternative therapeutic regimes with variable success rates. The development of effective salvage treatments is of paramount importance in this situation.

The research team led by Jaime Natan Eisig, from Brazil addresses this question and this will be be published on October 28; 2008 in the World Journal of Gastroenterology.

The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for seven days. Patients were considered as eradicated when samples taken from the gastric antrum and corpus twelve weeks the end of treatment were negative for H pylori (rapid urease test and histology). Safety was determined by the adverse effects.

In this study, fifty one patients were enrolled. The eradication rate was 68.8% (31/45). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effect. Their result indicated that the association of bismuth, furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for peptic ulcer patients.