Previous studies have demonstrated that the eradication of Helicobacter pylori (H. pylori) is associated with a significant reduction of the rate of
duodenal ulcer (DU) relapse. The aim of this study was to assess the long-term effect of a
bismuth-free triple
therapy on the eradication of H. pylori and reduction of DU relapse. After informed consent, 61 patients with endoscopically proven DU and H. pylori
infection detected on 14C-urea breath test (BT) were included in the study. All patients received a combination of
furazolidone,
amoxicillin, and
metronidazole, three times a day, for 5 days, in addition to eventual classical antiulcer agents prescribed by their attending physicians. BT was repeated after an interval of at least 60 days to evaluate H. pylori eradication. Endoscopy and another BT were performed again at 6.5 months after
therapy to detect possible recurrences. Forty-eight patients completed the trial: 26 (54%) patients were negative for H. pylori at 6.5 months after the end of treatment, and 22 (46%) persisted H. pylori positive. Ninety-two percent of the patients in whom the bacteria were eradicated showed endoscopically healed
ulcers and were asymptomatic, and two that were symptomatic presented only occasional
pain not requiring
therapy. Among the 22 patients who persisted H. pylori positive, six (27%) showed endoscopically active
ulcers (p = 0.012) and eight (36%) patients continued to be symptomatic (p less than 0.01), and were still using antiulcer drugs (p = 0.002) 6.5 months
after treatment. It is concluded that combined treatment with
furazolidone,
amoxicillin, and
metronidazole for 5 days represents a well-tolerated, inexpensive, and effective therapeutic regime for the eradication of H. pylori and abolition of DU relapse in more than 50% of the patients during a follow-up period of 6.5 months.