Terapia cuádruple con furazolidona como tratamiento de rescate para la infección por Helicobacter pylori

therapeutic failures are often seen in the treatment of h. pylori (hp) infection; different studies show that this can happen in 10 to 20% of cases. the principal factors involved in the lack of success are: primary resistance to antibiotics and the non compliance to treatment. the objective of the present work is to evaluate the efficacy and tolerance of a quadruple formulation with furazolidone in patients with persistent infection after several trials to eradicate hp. materials and methods. this is a prospective work done with adult patients aged 18 to 75 years, to whom a persistent hp infection was found at least six weeks after one or several treatments for its eradication. all of them received oral treatment with the following scheme during 10 days: omeprazole, 20 mg fasting and before supper, tetracycline chlorhydrate 500 mg four times a day, amoxicillin, 500 mg four times a day, and furazolidone, 100 mg four times a day (otaf 10). the outcome variable was the eradication of hp: absence of the infection proven by the three methods used: urea respiratory test, histopathology and fast urease test. this variable was analysed on an "intention to treat" basis. patients taking at least 80% of each drug were included in the "per protocol" analysis. the eradication rate was expressed as a percentage with confidence intervals of 95% results. ninety patients were studied, 62% women. age average was 44,3 ± 12.9 years. hp was eradicated as treatment intention in 81.1%, ci 95%, 71.2 to 83.3%; and 83.9% by protocol, ci 95%, 73.7 to 90%. adverse side effects were present in 20% of patients. only three patients withdrew because of headaches, diarrhea and rash respectively. conclusion: otaf 10 is an acceptable strategy as an empirical rescue treatment after treatment failures for its 80% efficacy, low cost, tolerance and safety.