Background and study aims‎: to evaluate efficacy of Furazolidone versus clarithromycin in quadruple therapy for eradication of ‎Helicobacter Pylori (HP) infection‎ ‎‎.
Patients and Method: During a period of six months, all of the cases with HP infection in 3 referral tertiary centers ‎included. The participants randomly allocate to receive either clarithromycin or Furazolidone base ‎quadruple regimen. For all of the participants pantoprazole continued for 4 more weeks and after 1 ‎to 2 weeks of off therapy, they underwent Urea Breath Test to prove eradication‎‎.
Results: Overall 386 patients included (165 male (42%), average age 44.2y).  They diagnosed as non-ulcer ‎dyspepsia (311 cases), peptic ulcer disease (34 cases) and intestinal metaplasia (45 cases). The ‎participants randomly allocated to groups A & B to receive either clarithromycin or Furazolidone.‎ In groups A and B, 80.9% & 82.1% of participants achieved eradication respectively (P = 0.819). ‎During study, there was not any major complication but 3.1% of participants in each group ‎reported minor side effects including bitter taste, Gastrointestinal (GI) upset, headache and or ‎vertigo. In sub group analysis, the eradication rate of clarithromycin among patients with non-ulcer ‎dyspepsia, peptic ulcer disease (PUD) and intestinal metaplasia were 80%, 100% & 55.6% ‎respectively. These figures in group B (Furazolidone) were 80.7%, 100% & 85.7% respectively ‎‎(P= 0.906, 0 & 0.162). Overall, there was no significant difference in success rate between ‎clarithromycin and Furazolidone but in cases with intestinal metaplasia, the positive results with ‎Furazolidone was more (85.7% vs. 55.6%)‎‎.
Conclusion: In areas with high rate of resistance to clarithromycin, Furazolidone could be a potential candidate ‎in HP eradication regimen and in cases with intestinal metaplasia; Furazolidone could be even ‎more efficient than clarithromycin‎‎.