Outcomes of furazolidone-and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication

AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication.

Furazolidone-based triple and quadruple eradication therapy for Helicobacter pylori infection

AIM: To evaluate the efficacy of furazolidone-based triple and quadruple therapy in eradicating Helicobacter pylori (H. pylori) in a multi-center randomized controlled trial.

Furazolidone,amoxicillin,bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori

AIM： To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori （H pylonS. METHODS： Patients who failed in the Hpylori eradication therapy for at least one course were randomly allocated into three groups. Group A received rebaprazole 10 mg＋ amoxicillin 1 g ＋ furazolidone 100 mg, and bismuth subcitrate 220 mg, twice daily for 1 wk; group B received the same regimen of group A but for 2 wk; and group C received the same regimen of group B, but furazolidone was replaced by furazolidone 100 mg three times daily. To record the side effect profiles at the end of the treatment, Hpylori eradication was assessed with 13C-urea breath test 4 wk after therapy. RESULTS： Sixty patients were enrolled including 28 males, and 20 patients in each group. The average age of the patients was 49.2 years, ranging from 18 to 84 years. H pylori eradication rates with per-protocol analysis were 82%, 89% and 90% in the three groups, respectively. Side effects were found in 11 patients, including mild dizziness, nausea, diarrhea and increased bowel movement. None of the 11 patients needed treatment for their side effects. CONCLUSION： One- or two-week furazolidone and amoxicillin-based quadruple rescue therapy with a low dose furazolidone （100 mg bid） for the eradication of Hpylori is effective. Extending the antibiotic course to 14 d could improve the eradication rates.

Resistance of Helicobacter pylori to furazolidone and levofloxacin: A viewpoint

In their review, Arslan et al[1] did not describe the status of Helicobacter pylori(H. pylori) treatment with furazolidone and the resistance to this antibiotic. We have presented different surveys showing the resistance of H. pylori to furazolidone from Asia and South America. The resistance rates varied but were mostly low(< 5%). There are not enough data on its efficacy and resistance in the United States and Europe. H. pylori mutations occurring in the oor D gene, including A041 G, A122 G, C349A(G), A78 G, A112 G, A335 G, C156 T and C165 T, and in the por D gene, including G353 A, A356 G, C357 T, C347 T, C347 G and C346 A, have been indicated to be possibly related to the observed resistance. Additionally, to complete Arslan et al 's statement regarding levofloxacin resistance, it should be noted that compound mutations of N87 A, A88 N and V65 I at codon Asn-87 were recently observed in the gyr A gene for the first time. However, the results on these topics are not sufficient, and more worldwide studies are suggested.

Design and efficient synthesis of novel haptens and complete antigens for the AOZ,a toxic metabolite of furazolidone

A good strategy was brought forward for designing efficient haptens and complete antigens for 3-amino-2-oxazolidinone （AOZ）. Haptens designed newly were achieved facilely in good yield by using LiCI-N（Et）3 as new catalysis system, the structure of which was elucidated by spectroscopy analysis, such as NMR and MS. Novel antigens for AOZ were prepared successfully by convenient active ester method. The ratios of haptens 3 and 4 to carrier proteins were proven respectively as 41 ： 1 （5a）, 39：1 （6a）, 11：1 （5b） and 9：1 （6b） by trinitrobenzene sulfonic acid （TNBS） method. The results of indirect competitive ELISA （ic-ELISA） of antiserums indicated that the haptens with a short unsaturated side chain can evoke specific immune response effectively.

Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole,bismuth subcitrate,furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens.The therapeutic regimen consisted of 20 mg omeprazole,240 mg colloidal bismuth subcitrate,1000 mg amoxicillin,and 200 mg furazolidone,taken twice a day for 7 d.Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology).Safety was determined by the presence of adverse effects.RESULTS: Fifty-one patients were enrolled.The eradication rate was 68.8% (31/45).Adverse effects were reported by 31.4% of the patients,and these were usually considered to be slight or moderate in the majority of the cases.Three patients had to withdraw from the treatment due to the presence of severe adverse effects.CONCLUSION: The association of bismuth,furazolidone,amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens.It is an effective,cheap and safe option for salvage therapy of positive patients.

Furazolidone therapy for Helicobacter pylori:Is it effective and safe?

Some aspects related with the use of furazolidone as a rescue therapy for Helicobacter pylori （H pylorl） infection should be remarked, especially regarding its potential oncologic risk. The inclusion of furazolidone in a treatment regimen for H pylori infection is, at least, controversial, and it does not appear to be safe.

Furazolidone-based triple therapy for H pylori gastritis in children

AIM： To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastdtis. METHODS： A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive ^13C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone （100 mg, 200 mg if over 30 kg） twice daily. Eradication of H pylori was assessed two months after treatment by histology and ^13C-urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS： Thirty-eight patients （24 females, 14 males） were included. Their age ranged from 4 to 17.8 （mean 10.9 ± 3.7） years. On intent-to-treat analysis （n = 38）, the eradication rate of H pylori was 73.7% （95% CI, 65.2%-82%） whereas in per-protocol analysis （n = 33） it was 84.8% （95% CI, 78.5%-91%）. All the patients with duodenal ulcer （n = 7） were successfully treated （100% vs 56.2% with antral nodularity）. Side effects were reported in 26 patients （68.4%）, mainly vomiting （14/26） and abdominal pain （n = 13）. Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of Hpylori-positive patients after six months of treatment. CONCLUSION： Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.

Furazolidone-induced pulmonary toxicity in Helicobacter pylori infection:Two case reports

BACKGROUND Helicobacter pylori(H.pylori)infection is a global problem,causing significant morbidity and mortality.Furazolidone is recommended to eradicate H.pylori infections in China owing to the highly associated antibiotic resistance.CASE SUMMARY This article presents two cases of lung injury caused by furazolidone treatment of H.pylori infection and the relevant literature review.Two patients developed symptoms,including fever,cough,and fatigue after receiving a course of furazolidone for H.pylori infection.Chest computed tomography showed bilateral interstitial infiltrates.Laboratory studies revealed elevated blood eosinophil count.After discontinuing furazolidone with or without the use of corticosteroids,the symptoms improved rapidly.A PubMed database literature search revealed three reported cases of lung injury suggestive of furazolidone-induced pulmonary toxicity.CONCLUSION Clinicians should be aware of the side effects associated with the administration of furazolidone to eradicate H.pylori infection.

Molecularly imprinted sensor based on carboxylated carbon nanotubes/Keggin-type polyoxometalates nanocomposite for the detection of furazolidone

Due to its properties of mutagenic,teratogenic,and carcinogenic,the detection of furazolidone(FZD)in aquaculture is of great importance for food safety and human health.In this study,molecularly imprinted fi lms modifi ed with carboxylated multi-walled carbon nanotube-phosphomolybdic acid composite were used to fabricate an electrochemical sensor for the determination of FZD.The nanocomposites were characterized using infrared spectroscopy,scanning electron microscopy,energy-dispersive X-ray spectroscopy,and X-ray diff raction.The electrochemical characteristics of the modifi ed electrodes were examined using electrochemical impedance spectroscopy,cyclic voltammetry,and diff erential pulse voltammetry.The sensor exhibited exceptional catalytic performance.The calibration curves were acquired in the concentration range of 6 nmol·L^(−1)to 0.6μmol·L^(−1),with a limit of detection of 3.38 nmol·L^(−1).Additionally,the sensor proved successful in recognizing FZD in shrimp samples with satisfactory recoveries and precision.The method provides a strategy to construct a molecularly imprinted electrochemical sensing platform using nanomaterials,which has great promise in the field of food safety.

Solvation dynamics of furazolidone in pure organic solvents and aqueous EDTA disodium salt mixtures:molecular interactions and thermodynamic insights

This study systematically examined the dissolution behavior of furazolidone in 12 different pure solvents and in aqueous solutions containing ethylenediaminetetraacetic acid disodium salt(EDTA-2Na).The solubility data indicated that polar aprotic solvents demonstrated a marginally higher solubility of furazolidone compared to alcohols and water.Interestingly,a co-solvency effect was observed in the aqueous solutions of EDTA-2Na,where the solubility of furazolidone initially increased and then decreased with the gradual addition of EDTA-2Na,peaking at a mass fraction of 0.03(1.949×10^(–5)at 323.15 K).The analysis using the Kamlet-Abboud-Taft Linear Solvation Energy Relationship(KAT-LSER)model suggested that the dissolution of furazolidone in these systems was predominantly influenced by non-specific solute-solvent and solvent-solvent interactions.Furthermore,Hansen solubility parameter calculations revealed that N,N-dimethylformamide(DMF)and N,N-dimethylacetamide(DMAC)exhibited superior dissolution capabilities compared to other solvents.It was also found that the partial solubility parameters played a crucial role in determining the overall solubility behavior.

UPLC-MS/MS测定鱼干中的呋喃唑酮代谢物

A high performance liquid chromatography-tandem mass spectrometric method was established for determination of the nitrofuran metabolites were released.After adjusting pH range from 7.0 to 7.5. Then the analytes were extracted by ethyl acetate identification was achieved by electrospray ionization in positive mode(ESI+) using multiple reaction monitoring.The quantification was performed with external standards.The recoveries of 3-Amino-2-oxazolidinone(AOZ)were in the range of 79.1%-94.8% with spiked levels of 0.5-2 μg/kg.The RSD were less than 8.23%.The limits of detection were 0.10 μg/kg for AOZ.

四环素与呋喃唑酮四联方案与常规方案治疗藏族地区Hp阳性慢性萎缩性胃炎的效果分析

目的探讨四环素和呋喃唑酮四联方案与常规方案治疗藏族地区幽门螺旋杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的效果,并尝试探讨其作用机制。方法前瞻性纳入2020年6月至2022年12月西藏自治区人民政府驻成都办事处医院收治的藏族地区Hp阳性CAG患者80例。根据随机抽签法分成实验组与对照组,每组各40例。实验组采用四环素和呋喃唑酮四联方案治疗,对照组采用常规方案治疗。比较两组临床疗效,分别在治疗前及疗程结束后,采集病变部位明显的胃黏膜进行病理评分,并比较两组血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素17(GA17)、白细胞介素-6(IL-6)、可溶性IL-2受体(sIL-2R)水平。记录两种方案的不良反应情况。结果实验组的疗效等级优于对照组,差异有统计学意义(P<0.05)。治疗后,两组胃黏膜炎症、肠上皮化生、腺体萎缩评分均低于治疗前,且实验组胃黏膜炎症、肠上皮化生评分分别为(1.05±0.16)、(1.10±0.47)分,均低于对照组[(1.31±0.27)、(1.36±0.28)分],差异均有统计学意义(P<0.05)。治疗后,两组血清PGⅡ水平均低于治疗前,PGⅠ、GA17水平均高于治疗前,且实验组血清GA17水平为(1.19±0.28)nmol/L,高于对照组[(0.94±0.34)nmol/L],差异均有统计学意义(P<0.05)。治疗后,两组血清IL-6、sIL-2R水平均低于治疗前,且实验组血清IL-6、sIL-2R水平分别为(25.62±5.12)ng/mL、(308.74±29.75)KU/L,均低于对照组[(30.48±6.90)ng/mL、(341.06±25.74)KU/L],差异均有统计学意义(P<0.05)。实验组不良反应率为5.00%,与对照组的12.50%比较,差异无统计学意义(P>0.05)。结论四环素和呋喃唑酮四联方案能提高藏族地区Hp阳性CAG患者的临床治愈率,减轻病理症状,上调血清GA17水平,作用机制可能与其调控IL-6、sIL-2R有关。

含呋喃唑酮四联疗法治疗耐药幽门螺杆菌感染老年患者的临床效果研究

目的分析含呋喃唑酮四联疗法治疗耐药幽门螺杆菌(Hp)感染老年患者的临床效果。方法选择100例耐药幽门螺杆菌感染老年患者为研究样本,现结合受试者干预方式差异分为新式组(50例)、传统组(50例)。传统组使用阿莫西林+奥美拉唑+克拉霉素+胶体果胶铋方案治疗,新式组使用胶体果胶铋+阿莫西林+奥美拉唑+呋喃唑酮方案治疗。对比两组治疗总有效率,幽门螺杆菌清除时间,干预前后血浆胃动素、胃泌素水平,不良反应发生率。结果传统组治疗总有效率为82.00%,新式组为96.00%,相较于传统组,新式组治疗总有效率更高,组间数据存在统计学意义(P<0.05)。传统组幽门螺杆菌根除时间为(6.39±1.57)d,新式组幽门螺杆菌根除时间为(5.25±1.52)d,和传统组相比,新式组幽门螺杆菌清除时间明显更短,组间数据存在统计学意义(P<0.05)。干预后,新式组胃泌素为(73.25±3.92)pg/ml、血浆胃动素为(432.25±41.25)pg/ml,传统组分别为(88.36±4.28)、(345.26±40.27)pg/ml,相较于传统组,新式组的血浆胃动素、胃泌素水平改善情况更好,组间数据存在统计学意义(P<0.05)。传统组不良反应发生率为12.00%,新式组为10.00%,两组不良反应发生率无明显差别(P>0.05)。结论含呋喃唑酮四联疗法治疗耐药幽门螺杆菌感染老年患者能取得满意成效,值得进一步推广以及应用。

阿莫西林、奥美拉唑联合呋喃唑酮治疗胃溃疡的疗效分析

目的:探究应用阿莫西林、奥美拉唑联合呋喃唑酮治疗胃溃疡的效果。方法:选取2022年7月—2023年7月贵州省盘州市第二人民医院收治的93例胃溃疡患者作为研究对象,按照随机数字表法分为参照组和试验组。参照组(n=46)采用阿莫西林、奥美拉唑联合克拉霉素治疗,试验组(n=47)采用阿莫西林、奥美拉唑联合呋喃唑酮治疗。比较两组患者临床症状改善时间、炎性因子水平、溃疡愈合率、幽门螺杆菌(Hp)根除率及临床疗效。结果:试验组上腹疼痛、反酸、腹胀、嗳气等临床症状改善时间均短于参照组,差异有统计学意义(P<0.05)。试验组超敏C反应蛋白及白细胞介素-6水平低于参照组,白细胞介素-2水平高于参照组,差异有统计学意义(P<0.05)。试验组溃疡愈合率、Hp根除率及治疗总有效率显著高于参照组,差异有统计学意义(P<0.05)。结论:采用阿莫西林、奥美拉唑及呋喃唑酮联合治疗胃溃疡疗效显著,能快速改善患者临床症状,降低炎性因子水平,提高溃疡愈合率及Hp根除率。

雷贝拉唑为基础的五日疗法治疗幽门螺杆菌感染的疗效观察

目的 :观察以雷贝拉唑为基础的短程 5d疗法治疗幽门螺杆菌 (H .pylori)感染的疗效 ,了解雷贝拉唑、克拉霉素及呋喃唑酮联合用药能否解决近年来H .pylori根除率下降的问题。方法 :95例伴幽门螺杆菌感染的消化性溃疡及糜烂性胃炎患者 ,随机分为 2组 ,选用雷贝拉唑 10mg、克拉霉素 5 0 0mg及呋喃唑酮 10 0mg ,均为每天 2次口服 ,进行 5d疗法 (5dRCF组 )与 7d疗法 (7dRCF组 )对照观察 ,用药结束后 2 8d复查胃镜、14 C呼气试验及病理检查 ,了解 2组H .pylori根除率、药物副作用及溃疡愈合情况。结果 :H .pylori根除率 ,(1)ITT分析 :5dRCF组为77.8% ,7dRCF组 82 % (P >0 .2 5 ) ;(2 )PP分析 :5dRCF组为 94 .4 % ,7dRCF组为 97.6 % (P >0 .5 )。 2组副作用均少见 ,继续服药不影响治疗。溃疡及糜烂愈合情况 ,5dRCF组为 97.6 % ,7dRCF组为 97.8% (P >0 .2 5 )。结论 :以雷贝拉唑为基础的联合克拉霉素及呋喃唑酮的短程 5d疗法治疗幽门螺杆菌感染的疗效确定 ,根除率高 ,副作用小 ,进一步提高了抗H .pylori治疗的依从性 ,是有前途的根除H .

高效液相色谱/串联质谱法测定奶粉中的硝基呋喃代谢物

用高效液相色谱/串联质谱(LC-MS/MS)法同时测定奶粉中呋喃唑酮、呋喃它酮、呋喃西林和呋喃妥因的代谢物.盐酸水解奶粉中蛋白结合的代谢物,同时加入2-硝基苯甲醛(2-NBA),37℃过夜衍生化.加入硫酸锌,调pH值至7.0后,再加入亚铁氰化钾去除蛋白.后用乙酸乙酯提取,正己烷净化,分析物采用电喷雾电离正离子(ESI+)、多反应监测(MRM)模式检测,内标法定量.在添加浓度0.5～2 μg/kg范围内,内标法回收率为89.5%～110.3%;相对标准偏差(RSD)小于11.3%.5-马啉代甲基-3-氨基-2-恶唑酮(5-methylmorpholino-3-amino-2-oxazolidinone, AMOZ)、3-氨基-2-恶唑酮(3-amino-2-oxazolidinone, AOZ)方法检出限为0.05 μg/kg,氨基脲(semicarbazide, SEM)、1-氨基-乙内酰胺(1-amino-hydantoin, AHD)为0.1 μg/kg.

超高效液相色谱法测定水产品中违禁兽药氯霉素、呋喃唑酮和甲硝唑残留

建立了超高效液相色谱(UPLC)同时测定水产品中氯霉素、呋喃唑酮和甲硝唑3种兽药的分析方法。样品采用乙酸乙酯提取,无水Na2SO4脱水,减压浓缩至干,用甲醇溶解,正己烷脱脂。采用ACQUITYTMUPLCBEHC18色谱柱(100 mm×2.1 mm,1.7μm),以乙腈-0.004%H3PO4溶液为流动相梯度洗脱,结合波长变化程序,在7.0 min内可完成3种违禁兽药的多残留检测。在0.01～10 mg/L线性范围内,线性相关系数r为0.9997,检出限(LOD)为0.01 mg/L,最低定量限(LOQ)为1.0μg/kg。空白样品中4个添加水平(1、2、5和10μg/kg)下,3种违禁兽药的平均回收率为72.3%～119.6%;日内及日间相对标准偏差为2.2%～9.9%。

水解衍生-酶联免疫分析在动物肌肉中呋喃唑酮代谢物残留量检测中的应用

目的:优化并评估了水解衍生-酶联免疫方法在测定动物肌肉中抗生素呋喃唑酮代谢后结合残留物中的应用。方法:样品中的呋喃唑酮代谢物3-氨基-唑烷酮(3-amino-2-oxazolidone,AOZ)的蛋白结合残留物经酸水解释放 AOZ,经2-硝基苯甲醛(2-nitrobenzaldehyde,NBA)衍生生成3{[(2-nitrophenyl)methylene]-amino}-2-oxazolidinone(NPAOZ)后,调 pH 至7.2-7.4,经乙酸乙酯萃取后,10min/4000r·min^(-1)离心取上层氮气流于30℃吹干并用缓冲液溶解,正己烷脱脂后取下层水相进行 NPAOZ 的竞争性酶联免疫吸附分析(Enzyme linked immunosorbent assay,ELISA)。结果:方法定量检测限为200ng·kg^(-1),样本加标水平为1.0μg·kg^(-1)时,回收率在85%以上。实际样本对照实验显示 AOZ 质量浓度>1.0μg·kg^(-1)时,方法与 LC-MS-MS 结果的相对误差<25%。结论:此方法可实现动物肌肉中呋喃唑酮代谢物残留量的高通量筛选。

高效液相色谱法测定鸡蛋中呋喃唑酮的残留量

采用基体固相扩散和固相萃取相结合的技术 ,对鸡蛋中呋喃唑酮残留进行了提取和净化处理 ,建立了高效液相色谱法检测鸡蛋中呋喃唑酮残留量的方法。对呋喃唑酮在C18固定相和硅胶固相萃取柱上的保留行为进行了研究。采用液相色谱分离 ,外标法定量 ,呋喃唑酮标准溶液的峰面积与样品浓度在 5 μg/L～ 2 5mg/L范围内呈良好的线性关系 ,线性回归系数大于 0 .9999。鸡蛋样品中呋喃唑酮不同加入量的平均回收率在 80 .2 %～ 91.1% ;相对标准偏差在 2 .0 %～ 9.5 % ;最低检出限为 10 μg/kg。分析方法具有良好的重现性 ,批内、批间定量结果的相对标准偏差均小于 10 %。