چكيده لاتين :
Helicobacter pylori (H Pylori) infection is currently recognized
as the major cause of chronic active gastritis, peptic ulcer
disease and mucosa associated lymphoid tissue (MALT)
lymphoma and carcinoma of the stomach. Eradication of the
infection will prevent the recurrence of the majority of such
diseases. Different combined treatments have been tried in
Iran for eradication of H Pylori, but the optimal eradication
needs further evaluation. Herein, we have reviewed the
eradication regimens of H Pylori used by Iranian scientists
during a 16 year period from 1990 to 2006, regarding the
number, the type of drugs used, the duration, eradication rate,
and their side effects.
From 26 articles retrieved, 22 drug regimens were evaluated.
Triple drug therapy was favored in our country, as it consisted
of 63% of the regimens. But it could not achieve an optimal
eradication rate. Of eight quadruple drug regimens, two led to
an optimal eradication rate, with the highest eradication rate
being 92% based on furazolidone quadruple regimen. But
this regimen had significant side effects in more than 62% of
the patients.
The best first line treatment regimen for eradication of
H Pylori in Iran seems to be a type of furazolidone or
clarithromycin based quadruple therapy for a minimum duration
of two weeks. However, the patients should be monitored for
furazolidone side effects. Furthermore, in metronidazole based
quadruple therapy drug resistance is a major problem, even with
doses of more than 1 gm/day. In patients with treatment failure,
medication should be adjusted according to antibiotic sensitivity
and newer antibiotic therapies, which is designed as clinical
trials.
