潘妥洛克联合呋喃唑酮治疗幽门螺杆菌的效果

Safety of furazolidone-containing regimen in Helicobacter pylori infection: a systematic review and meta-analysis

OBJECTIVES

Furazolidone containing regimen is effectivefor Helicobacter pylori (H. pylori) infection, but its safetyremains controversial. To assess the safety of furazolidone containing regimenin H. pylori infection.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

PubMed, Embase, Cochrane Library, Web of Science and Scopus databases were systematically searched for eligible randomised controlled trials.

ELIGIBILITY CRITERIA

Studies comparing furazolidone with non-furazolidone-containing regimen, variable durations or doses of furazolidone were included.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently selected studies and extracted data. Primary outcomes were the risk of total adverse events (AEs), serious AEs and severe AEs, expressed as relative risk (RR) with 95% CI. Secondary outcomes contained the incidence of individual adverse symptoms, AE-related treatment discontinuation and compliance.

RESULTS

Twenty-six articles were identified from 2039 searched records, of which 14 studies (n=2540) compared furazolidone with other antibiotics. The eradication rates of furazolidone-containing regimen were higher than those of other antibiotics in both intention-to-treat (RR 1.06, 95% CI 1.01 to 1.12) and per-protocol analysis (RR 1.05, 95% CI 1.00 to 1.10). Only two serious AEs were reported in furazolidone group (2/1221, 0.16%). No significant increased risk was observed for the incidence of total AEs (RR 1.04, 95% CI 0.89 to 1.21) and severe AEs (RR 1.81, 95% CI 0.91 to 3.60). Twelve studies (n=3139) compared different durations of furazolidone, and four studies (n=343) assessed variable doses. Elevated risk of total AEs and severe AEs were only found in a high daily dose of furazolidone rather than prolonged duration. The incidence of AE-related treatment discontinuation and compliance of patients were all similar, irrespective of dose and duration adjustments.

CONCLUSION

Furazolidone-containing regimen has a similar risk of AEs and compliance as non-furazolidone-containing regimen. A low daily dose of 200 mg is well-tolerated for 14 day regimen and should be first considered.

PROSPERO REGISTRATION NUMBER

CRD42019137247.

Ozone improves efficacy of standard quadruple therapy for Helicobacter pylori eradication

AIM: To explore the effect of ozone water therapy on efficacy and adverse reactions of standard quadruple therapy for Helicobacter pylori (H. pylori) infection.

METHODS: From October 2013 to April 2015, 200 patients with H. pylori infection were collected and equally divided into an ozone water therapy with standard quadruple therapy group and a standard quadruple therapy alone group. Each group received omeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg and bismuth potassium citrate 220 mg twice daily for 10 d, and the combination group additionally received ozone water twice daily for 15 d. At 4 wk after the end of therapy, the patients underwent the ¹³C-urea breath test. The negative result indicated successful H. pylori eradication. Adverse reactions were also recorded during treatment.

RESULTS: All the 200 patients completed the follow-up. According to intention to treat (ITT) analysis, the eradication rates for the two groups were 91.0% (91/100) and 80.0% (80/100), respectively. According to per protocol (PP) analysis, the rates were 93.8% (91/97) and 81.6% (80/98), respectively. The differences in the eradication rates between the two groups were statistically significant (P < 0.05). The rates of nausea, vomiting, diarrhea and abdominal bloating for the two groups were 4.0% (4/100) vs 13.0% (13/100), 4.0% (4/100) vs 8.0% (8/100), 6.0% (6/100) vs 8.0% (8/100). The differences in the rates of nausea and vomiting between the two groups were statistically significant (P < 0.05).

CONCLUSION: Ozone can improve the efficacy of standard quadruple therapy for H. pylori eradication, and reduce the rates of adverse reactions during treatment.