a comparison between moderate- and high-dose furazolidone in triple regimens for helicobacter pylori eradication in iran

background: furazolidone has been used as an alternative for clarithromycin or metronidazole in helicobacterpylori ( h . pylori ) eradication regimens.  in iran, 14-day furazolidone-containing quadruple regimens have shown promising eradication rates, but short-course, low dose therapies are always attractive. therefore, we designed a study to compare the efficacy of two 10-day triple regimens containing moderate and high dose furazolidone for h . pylori eradication. method: two hundred and ten patients with peptic ulcer disease who were naïve to h. pylori treatment were included. they were randomized into 2 groups: 105 patients received omeprazole 20mg, amoxicillin 1000mg, and furazolidone 200mg(oaf-400), all twice a day for ten days.and the remaining 105 patients received omeprazole 20mg twice a day, amoxicillin 1000mg twice a day and furazolidone 200mg three times a day for ten days(oaf-600). urease breath test was performed 8 weeks after the treatment to confirm h . pylori eradication. results: the intention-to-treat eradication rate was 76.19% in group oaf-400 and 80.95% in group oaf-600 ( p =0.38). per protocol eradication rates were 81.63% and 89.47%, respectively ( p = 0.11).severe adverse effects were reported by 8.6% of the patients in group oaf-400 and 5.7% of the patient in group oaf-600 ( p =0.1). however, the total side effects (including mild, moderate, and severe ones) were significantly more prevalent in the oaf-600 group ( p =0.001). conclusion: none of our triple furazolidone-based  regimens (moderate- and high-dose) could achieve the standard eradication rate, and therefore, cannot be considered as a suitable option for first-line treatment.