Once-daily, low-cost, highly effective Helicobacter pylori treatment to family members of gastric cancer patients

Background: Helicaobacter pylori eradication in family members of gastric cancer patients is now widely accepted, although problems related to costs and compliance persist. Aim: To compare the efficacy, tolerability and long-term re-infection rates of two once-daily regimens for the eradication of H. pylori in family members of gastric cancer patients. Methods: 106 first-degree family members of gastric cancer patients were recruited and submitted to the C-13-urea breath test (UBT) to detect H. pylori . If positive, they were randomly allocated to receive a combination of lanzoprazole 30 mg, clarithromycin OD (extended-release formulation) 500 mg and furazolidone 400 mg, once daily, in the morning, for 7 days (Group A) or the same regimen with only 200 mg furazolidone (Group B). Eradication was confirmed by urea breath test performed 6 weeks after treatment. C-13-urea breath test was repeated at 944 (784-1258) days after treatment in successfully treated participants to look for re-infection. Results: Twenty-five participants were H. pylori negative and two H. pylori -positive individuals refused to sign the informed consent and were excluded. Therefore, 79 participants were studied. Forty participants were allocated to Group A and 39 to Group B. All participants completed treatment. Adverse effects, mostly mild, were observed in 18% of Group A and 18% of Group B (N.S.). The intention-to-treat eradication rate was 87.5% in Group A and 61.5% in Group B (P = 0.006). The mean annual re-infection rate was 3%. Conclusions: The combination of lanzoprazole 30 mg, one tablet of clarithromycin OD (extended release formulation) 500 mg and furazolidone 400 mg, once daily for 7 days, constitutes an inexpensive, safe and effective alternative for anti-H. pylori therapy in family members of gastric cancer patients.