Experiences with Helicobacter Pylori Treatment in Iran

Helicobacter pylori (h pylori) infection is currently recognizedas the major cause of chronic active gastritis, peptic ulcerdisease and mucosa associated lymphoid tissue (malt)lymphoma and carcinoma of the stomach. eradication of theinfection will prevent the recurrence of the majority of suchdiseases. different combined treatments have been tried iniran for eradication of h pylori, but the optimal eradicationneeds further evaluation. herein, we have reviewed theeradication regimens of h pylori used by iranian scientistsduring a 16 year period from 1990 to 2006, regarding thenumber, 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 consistedof 63% of the regimens. but it could not achieve an optimaleradication rate. of eight quadruple drug regimens, two led toan optimal eradication rate, with the highest eradication ratebeing 92% based on furazolidone quadruple regimen. butthis regimen had significant side effects in more than 62% ofthe patients.the best first line treatment regimen for eradication ofh pylori in iran seems to be a type of furazolidone orclarithromycin based quadruple therapy for a minimum durationof two weeks. however, the patients should be monitored forfurazolidone side effects. furthermore, in metronidazole basedquadruple therapy drug resistance is a major problem, even withdoses of more than 1 gm/day. in patients with treatment failure,medication should be adjusted according to antibiotic sensitivityand newer antibiotic therapies, which is designed as clinicaltrials.