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Furazolidone-based triple therapy for H pylori gastritis in children.

AIM: To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis. METHODS: A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive (13)C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone (100 mg, 200 mg if over 30 kg) twice daily. Eradication of H pylori was assessed two months after treatment by histology and (13)C -urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS: Thirty-eight patients (24 females, 14 males) were included. Their age ranged from 4 to 17.8 (mean 10.9 +/- 3.7) years. On intent-to-treat analysis (n = 38), the eradication rate of H pylori was 73.7% (95% CI, 65.2%-82%) whereas in per-protocol analysis (n = 33) it was 84.8% (95% CI, 78.5%-91%). All the patients with duodenal ulcer (n = 7) were successfully treated (100% vs 56.2% with antral nodularity). Side effects were reported in 26 patients (68.4%), mainly vomiting (14/26) and abdominal pain (n = 13). Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of H pylori-positive patients after six months of treatment. CONCLUSION: Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.

Adolescent↗

[Determination of furazolidone, carbenoxolone sodium and berberine hydrochloride in wei kang tablets by reversed-phase high performance liquid chromatography(RP-HPLC)].

An HPLC method with gradient elution was developed to separate and determine furazolidone, carbenoxolone sodium and berberine hydrochloride in Wei Kang Tablets on Nova-Pak C18 column (150 mm x 3.9 mm i.d., 4 microns), using acetonitrile-phosphate buffer solution (pH 7.0) as mobile phase and 3,5-dinitrobenzoic acid as the internal standard. Detection was performed with UV detector at 254 nm. The calibration curves were linear within the ranges of 141.2 mg/L -1,270.8 mg/L for furazolidone(r = 0.9997), 100.6 mg/L -905.4 mg/L for carbenoxolone sodium(r = 0.9995) and 99.2 mg/L -892.8 mg/L for berberine hydrochloride(r = 0.9991). The recoveries and RSDs were 99.5% and 1.38% for furazolidone, 100.3% and 1.73% for carbenoxolone sodium, 97.3% and 1.97% for berberine hydrochloride respectively. The results show that this method is simple, rapid, specific, accurate and reproducible.

Anti-Ulcer Agents↗

Antimicrobial effectiveness of furazolidone against metronidazole-resistant strains of Helicobacter pylori.

The occurrence of strains resistant to metronidazole is causing failure of the 4-drug regimen for eradication of Helicobacter pylori in the Islamic Republic of Iran. This study compared the in vitro efficacy of furazolidone with metronidazole, clarithromycin, amoxicillin and tetracycline in 70 H. pylori isolates from dyspeptic patients. Of the isolates, 33% were resistant to metronidazole but all were susceptible to furazolidone. Furazolidone could be considered as an appropriate substitute for metronidazole for H. pylori infections.

Amoxicillin↗

Serum chemistry alterations, including creatine kinase isoenzymes, in furazolidone toxicosis of ducklings: preliminary findings.

Furazolidone induces a cardiotoxicosis when fed in toxic concentrations to newly hatched ducklings. This preliminary experiment was designed to determine if creatine kinase (CK) isoenzymic activities or other serum analytes would be useful as indicators of these cardiac alterations. Sera from 12 ducklings (six fed a control ration and six fed the control ration with 700 mg furazolidone added per kg of feed [700 ppm] for 28 days) were analyzed for CK isoenzymic activities, electrolytes, nitrogenous metabolites, hepatic enzymic activities, bilirubin, and glucose. Statistically significant differences between control and treated groups were detected for creatine kinase MB (CK-MB, cardiac muscle origin) isoenzymic activity and bilirubin, potassium, calcium, and total carbon dioxide concentrations. Differences other than CK-MB isoenzymic activity were generally explained by factors related to the toxicosis or sample handling. These findings suggest that CK-MB isoenzymic activity may be useful to detect and monitor the progress of cardiac injury in furazolidone toxicosis, thereby increasing the usefulness of this model of dilated cardiomyopathy. Our findings, analyzed on the Kodak Ektachem 700 Dry Chemistry Analyzer, are compared with serum chemistry values reported in the literature.

Acid-Base Equilibrium↗

[Furazolidone and cimetidine in patients with active duodenal ulcer and Helicobacter pylori in the gastric antrum].

In order to assess the effect of furazolidone on duodenal ulcer disease and Helicobacter pylori (Hp), a double-blind, double-dummy, randomized, prospective pilot study comparing furazolidone and cimetidine was carried out in 31 antral Hp positive patients with endoscopically proven active duodenal ulcer. Clinical, endoscopical, bacteriological and histological studies were done before and at four weeks of the study in all patients. If the ulcer was not healed, the treatment was extended for a further four weeks and all the procedures repeated. The healed ulcer patients were followed-up and re-endoscoped, regardless the presence of symptomatology, at least at 3 and 6mo after the end of treatment. It was observed that furazolidone cleared Hp (18% x 0%), healed the ulcer (91% x 87%) and reduced the relapse rate (30% x 92%; p < 0.025).

Adolescent↗

Effect of orally administered furazolidone on volume and sperm concentration of dwarf and non-dwarf cock semen.

2 groups of 20 cocks each were selected at random from non-dwarf White Leghorn (28 weeks post-hatch) and dwarf Krishna-J (38 weeks post-hatch) genotypes. The treated groups comprised 10 White Leghorn and 10 Krishna-J cocks. The remaining birds served as controls. 8 weeks prior to furazolidone treatment, semen was collected from both control groups at regular 4-day intervals, for 4 weeks. Cocks of the treated groups of both genotypes were administered furazolidone (0.14 g/bird/day) for 7 consecutive days. Semen was collected from all cocks at regular 4-day intervals for 4 weeks. Semen from the cocks of the same group was pooled. The pooled ejaculate volume and sperm density did not differ significantly in the 2 genotypes. The semen output as well as sperm density increased along with progressive attainment of sexual maturity. Furazolidone treatment caused significant reduction in semen volume as well as sperm concentration in either genotype.

Administration, Oral↗

Furazolidone-induced injury in the isolated perfused chicken heart.

The Langendorff isolated heart preparation was adapted to determine the effect of furazolidone (0.5 and 2 micrograms/ml of perfusate) on hearts of 3-week-old broiler chickens. Following 115 minutes of perfusion, both concentrations of furazolidone caused approximately a two-fold increase in myocardial vascular resistance and a six-fold increase in lactate dehydrogenase release into the effluent fluid, compared with a control perfused group of isolated hearts (P less than 0.01). Ultrastructural alteration differences were not found between the drug-treated and control groups. It was concluded that: (i) furazolidone, at concentrations only moderately above therapeutic plasma concentrations, caused detrimental changes in myocardial vascular resistance and lactate dehydrogenase release and (ii) the isolated chicken heart preparation is an example of a cost-effective, reliable laboratory tool for screening potential cardiotoxins.

Animals↗

[Carbadox in combination with furazolidone in the prevention of enteral and growth disorders in weaned piglets].

Two feed mixtures were produced, each containing the antimicrobial preparation Carbadox and different amounts of furazolidone. Their fortnightly administration in starters to piglets weaned at the age of 25--31 days prevented mortality and stimulated somatic growth and feed utilization. Premix with a higher content of furazolidone markedly depressed the clinical symptoms of gastro-enteritis and reduced the number of the haemolytic germs of E. coli in the contents of the duodenum and jejunum. The presence of furazolidone in the feed completely eliminated enteral disorders and delayed the onset of the disease, or alleviated its course, in cases of severe diarrhoea, which killed, in the control group, the piglets of the same litter. Weight gains were significantly increased, particularly in the first post-weaning week, the difference from the control being up to 520%. Almost 0.5 kg of the COS 2 starter was saved per 1 kg of piglet live weight gain. Under the current farming conditions of five agricultural enterprises the weight gains during the ten days of the administration of the medicated feed were increased, on an average by 0.84-1.32 kg. In herds where the untreated piglets put on less than 1 kg the gains were increased by 96--124%. It is recommended to administer the new-developed medicated premix to prevent losses due to alteration of the intestinal microflora in early-weaned piglets.

Animal Feed↗

Reductive metabolism of furazolidone by Escherichia coli and rat liver in vitro.

The metabolism of furazolidone by rat liver and Escherichia coli was characterized in vitro under aerobic and anaerobic incubation conditions. Rat liver 9000g supernatant rapidly metabolized 14C-furazo-lidone to more polar metabolites in the presence or absence of oxygen when NADPH was provided as a cofactor. At least five polar radiolabeled metabolites were detected in these incubations by high pressure liquid chromatography. Moreover, a significant (30-40%) proportion of the total radiolabeled metabolites remained tightly associated with liver protein despite repeated organic solvent extractions of the tissue. The major solvent-extractable metabolites produced under aerobic and anaerobic incubation conditions were isolated and analyzed by mass spectrometry. The mass spectra indicated that these derivatives possessed the same chemical structure. Subsequently, this metabolite was unequivocally identified as 3-(4-cyano-2-oxobutylideneamino)-2-oxazolidinone, an end product of reductive metabolism of the nitro group of furazolidone. The formation of the reduced metabolite under aerobic conditions indicated that this metabolic pathway was markedly less sensitive to oxygen than many previously studied nitroreduction reactions catalyzed by mammalian enzymes. This NADPH-dependent, oxygen-insensitive nitroreductase activity was further localized to the microsomal fraction of rat liver. E. coli also rapidly metabolized furazolidone (FZN) to a complex series of metabolites, including the reduced cyano metabolite, under both aerobic and anaerobic conditions. Sonic lysis of the bacteria released an NADPH-dependent, oxygen-insensitive nitroreductase which converted FZN to the cyano metabolite and other unidentified derivatives. The complete reduction of FZN by the solubilized bacterial enzyme was strongly inhibited by the addition of the thiol nucleophile glutathione to the incubation medium.

Animals↗

Simultaneous spectrophotometric determination of nifuroxime and furazolidone in pharmaceutical preparations.

Two spectrophotometric methods have been developed for the simultaneous determination of nifuroxime and furazolidone in their pharmaceutical preparations. No preliminary separation step is required in either method. The first, a modified Vierordt method, gives accurate and reproducible results for both drugs. Mean percent recoveries for nifuroxime and furazolidone were 99.50 +/- 1.59 and 100.20 +/- 1.16 (P = 0.05), respectively. This method also gives accurate and reproducible results for the determination of nifuroxime and furazolidone in their pharmaceutical preparations: Tricofuran vaginal suppositories and powder. The second method, which involves the use of the first-derivative curves, gives unreliable results; the reasons for these are discussed.

Drug Combinations↗

[Pharmacology and toxicology of furazolidone and carbadox; a literature study].

A literature search on furazolidone in pigs was made in order to be able to answer a number of questions raised by a court regarding possible furazolidone intoxication. The following review of the literature is the result of this study. Attention is also paid to the residual toxicology of this drug. As one of the court's questions concerned carbadox alone and combined with furazolidone, a brief review of the pharmacology of this drug is included.

Animals↗

Plasma and histological changes in furazolidone treated chickens.

Chickens were treated orally with furazolidone at dose rates of 40 or 80 mg kg-1 for five days or fed the drug at concentrations of 0.04 per cent w/w or 0.08 per cent w/w for 10 days. Plasma constituents, liver, heart, kidney, cerebrum, cerebellum and testes were examined. Furazolidone at the recommended therapeutic dose rate of 0.04 per cent w/w for 10 days or at a dose rate of 40 mg kg-1 for five days produced no significant changes in morphology or plasma parameters measured. At a dose rate of 0.08 per cent w/w for 10 days or 80 mg kg-1 for five days, furazolidone produced significant decreases in the concentrations of total protein and cholesterol and tended to increase the activity of cholinesterase. In the plasma, concentrations of potassium increased and concentrations of sodium decreased. Histologically, congestion and some degenerative changes were observed in the tissues examined.

Animals↗

High pressure liquid chromatographic determination of nitrofurazone and furazolidone in chicken and pork tissues.

A high pressure liquid chromatographic (HPLC) procedure is presented for the determination of nitrofurazone and furazolidone in chicken and pork tissues in the 2-40 ppb range. Muscle, liver, and kidney are homogenized with cold methanol and water (50 + 50). Following methanol evaporation, the nitrofurans are partitioned into ethyl acetate and cleaned up on an alumina column. After elution with 20% methanol in ethyl acetate and evaporation to dryness, residues are determined by HPLC, using a reverse phase analytical column. Overall average recoveries for nitrofurazone and furazolidone were 65.7 and 73.5%, respectively. Average relative standard deviations of 11.9% (nitrofurazone) and 9.5% (furazolidone) at the 2 ppb level were achieved.

Animals↗

High performance liquid chromatographic determination of furazolidone in feed and feed premixes.

Furazolidone is separated from finished feeds by acetone-water extraction on a Goldfisch apparatus. Extracting solvent is removed, and the residue is dissolved in dimethylformamide-5% tetraethylammonium bromide (1 +1), clarified, and chromatographed on a reverse phase C1 column. The mobile phase is CH3CN-2% acetic acid (20 + 80) with detection at 365 nm. The method was tested for linearity, recovery, and ruggedness, and compared with the AOAC colorimetric assay by using field samples containing 0.0055-0.055% furazolidone. Precision data suggest a cumulative relative standard deviation of 1.43% within days and 1.78% between days. The ruggedness test predicts a between-laboratory relative standard deviation of 3.67%. Recovery was 97.5 +/- 2.0% and linearity was excellent (r2 = 0.9994) up to 0.06% furazolidone. Premixes are extracted by shaking with dimethylformamide. An aliquot of the extract is diluted (1 + 1) with 5% tetraethylammonium bromide, clarified, and chromatographed.

Animal Feed↗

Sample preparation of carbadox, furazolidone, nitrofurazone, and ethopabate in medicated feeds for high pressure liquid chromatography.

Medicated feeds (pelleted or mash) containing guarantees of carbadox, furazolidone, nitrofurazone, and ethopabate are pretreated with water, extracted with 95% dimethylformamide overnight at room temperature, cleaned up on a column of alumina, and injected into a high pressure liquid chromatograph for quantitative measurement. Carbadox, nitrofurazone, and furazolidone can be separated; chromatograms show excellent baseline resolution, and results are in good agreement with colorimetric methods. The same extraction and cleanup can be used to improve colorimetric methods for furazolidone and nitrofurazone.

Aminobenzoates↗

Use of furazolidone for the treatment of microsporidiosis due to Enterocytozoon bieneusi in patients with AIDS.

The efficacy of furazolidone for treatment of intestinal microsporidiosis due to Enterocytozoon bieneusi was studied in three patients with AIDS. All patients had chronic diarrhoea and weight loss. Mean CD4 cell count was 34.6/mm3. A course of furazolidone (100 mg orally four times a day) was given for 20 days. The drug was well tolerated and neither side effects nor alterations in the laboratory parameters were noted. Diarrhoea ceased within a mean of 12 days of starting treatment and clearance of microsporidian shedding in stool was observed. In one of the patients, however, symptomatic microsporidiosis recurred. Therefore furazolidone seems to have a transient but significant effect on intestinal infection due to Enterocytozoon bieneusi.

Acquired Immunodeficiency Syndrome↗

[Dynamics of agglutination in birds artificially infected with Salmonella gallinarum-pullorum and Salmonella typhimurium and treated with sulfaguanidine and furazolidone].

Canadian Leghorn chickens were used to study the effect of sulfaguanidine and furazolidon on the dynamics of blood agglutinin formation. The birds were artificially infected with Salmonella gallinarum-pullorum and Salmonella typhimurium. At various intervals following infection they were treated with sulfaguanidine 1% tablets and 0.04% furazolidon. The level of agglutinins was determined by the methods of Huddleson (whole blood agglutination reaction), the fast serum agglutination, the method after Wright, and the indirect hemagglutination reaction. It was found that the agglutinin level in birds treated in the course of ten days with the chemotherapeutics mentioned prior to their infection did not change. The use of these chemotherapeutics parallel to the infection of the test birds and ten days later inhibited agglutinin formation. This was more pronouncedly expressed in birds treated with furazolidon. The delayed use of these therapeutic means did not inhibit substantially the level of blood agglutinins.

Agglutinins↗

Liquid chromatographic determination of furazolidone in shrimp.

A liquid chromatographic (LC) method was developed for the quantitation of furazolidone residues in shrimp muscle. The shrimp homogenate (1.0 g) is extracted with acetonitrile, and the extract is taken to dryness. The residue is dissolved in acetonitrile, and the solution is passed through alumina and C18 cleanup columns. The eluate is taken to dryness and reconstituted in a suitable solvent for reversed-phase (C18) LC with UV detection at 365 nm. Recoveries of furazolidone from shrimp homogenates spiked from 5 to 80 ng/g ranged from 74.3 to 79.7%, and relative standard deviations (RSDs) were 5.0-8.9%. RSDs for incurred furazolidone quantitated at 5.9 and 9.2 ng/g were 6.6 and 7.6%, respectively.

Animals↗