Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2018; 24(40): 4596-4605
Published online Oct 28, 2018. doi: 10.3748/wjg.v24.i40.4596
Outcomes of furazolidone- and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication
Ya-Wen Zhang, Wei-Ling Hu, Yuan Cai, Wen-Fang Zheng, Qin Du, John J Kim, John Y Kao, Ning Dai, Jian-Min Si
Ya-Wen Zhang, Wei-Ling Hu, Yuan Cai, Wen-Fang Zheng, Ning Dai, Jian-Min Si, Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Ya-Wen Zhang, Wei-Ling Hu, Wen-Fang Zheng, Jian-Min Si, Institute of Gastroenterology, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Qin Du, Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
John J Kim, Division of Gastroenterology, Loma Linda University, Loma Linda, CA 92354, United States
John Y Kao, Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, United States
Author contributions: Hu WL, Dai N and Si JM designed the study; Zhang YW, Cai Y and Zheng WF performed the research; Du Q contributed to providing support to patients; Zhang YW and Kim JJ analyzed the data; Zhang YW wrote the paper; Hu WL, Kim JJ and Kao JY critically revised the manuscript; all authors had access to the study data and had reviewed and approved the final version of the article.
Supported by the Zhejiang Science and Technology Project, No. LGF18H160012.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Sir Run Run Shaw Hospital.
Informed consent statement: Patients were not required to provide informed consent to the study because the data were obtained retrospectively after completing treatment.
Conflict-of-interest statement: The authors received grants from Zhejiang Science and Technology Project during the conduct of the study and declare no other conflict of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wei-Ling Hu, MD, PhD, Doctor, Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. huweiling@zju.edu.cn
Telephone: +86-571-86006181 Fax: +86-571-86006181
Received: July 1, 2018
Peer-review started: July 2, 2018
First decision: July 25, 2018
Revised: August 16, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 28, 2018
Processing time: 117 Days and 22.2 Hours
Core Tip

Core tip: This study examined the outcomes of furazolidone- and amoxicillin-based quadruple therapy as both primary and rescue therapies for Helicobacter pylori (H. pylori) infection in nearly a thousand patients. Detailed data on adverse events and factors associated with failed H. pylori eradication were evaluated. Furazolidone- and amoxicillin-based quadruple therapy demonstrated a high H. pylori eradication rate exceeding 90% with a favorable safety profile in a real-world setting. Abstinence from alcohol during therapy and strict medication adherence may further optimize eradication. The results validate updated guidelines recommending furazolidone-based quadruple therapy as a first-line treatment for H. pylori infection in areas with a high prevalence of clarithromycin resistance.