The findings of a recent study depicted that in areas with elevated resistance rate to clarithromycin, furazolidone could be a promising candidate ‎in the H. pylori elimination regimen, and in cases with intestinal metaplasia, furazolidone could be even ‎more efficient and is a better choice compared to clarithromycin‎‎.

Pezhman Alavinejad et al. performed this randomized multicentric clinical trial to determine the efficacy of furazolidone versus clarithromycin in quadruple therapy for eliminating ‎H. pylori infection‎. In total, 386 H. pylori-infected participants (average age 44.2 years) were randomly allocated to receive either clarithromycin or furazolidone based ‎quadruple regimen. For all the recruited individuals, the pantoprazole was continued for four more weeks and after one ‎to two weeks of off therapy, a urea breath test‎‎ was carried to determine elimination of H. pylori.

As found, 80.9% of clarithromycin-recipients and 82.1% of furazolidone-recipients attained H. pylori elimination. During the trial, there was not any major complication but 3.1% of participants in each group ‎reported minor side effects including headache, bitter taste, gastrointestinal upset, and vertigo.

In the subgroup analysis, the eradication rate of clarithromycin among patients with non-ulcer ‎dyspepsia, peptic ulcer disease, and intestinal metaplasia are shown below:

No vital difference in success rate between ‎clarithromycin and furazolidone was noted. But, in cases with intestinal metaplasia, the positive results with ‎furazolidone was more compared to clarithromycin (85.7% vs.55.6%)‎‎. Thus, furazolidone appears to yield satisfactory outcomes in H. pylori patients.