The Effectiveness of Different Eradication Schemes for Pediatric IHelicobacter pylori/I Infection—A Single-Center Comparative Study from Romania

Introduction: In Romania, studies on the pediatric population regarding H. pylori infection or bacterial resistance to antibiotics are limited. Eradication treatment of this infection still raises important problems in medical practice. This study aims to compare the effectiveness of three eradicati...

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Bibliographic Details
Published in:Children (Basel) 2022-09, Vol.9 (9)
Main Authors: Rosu, Oana-Maria, Gimiga, Nicoleta, Stefanescu, Gabriela, Ioniuc, Ileana, Tataranu, Elena, Balan, Gheorghe G, Ion, Laura-Mihaela, Plesca, Doina Anca, Schiopu, Cristina Gabriela, Diaconescu, Smaranda
Format: Article
Language:English
Subjects:
Antibacterial agents
Care and treatment
Drug resistance in microorganisms
Health aspects
Helicobacter infections
Helicobacter pylori
Infection
Metronidazole
Patient compliance
Pediatrics
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Summary:Introduction: In Romania, studies on the pediatric population regarding H. pylori infection or bacterial resistance to antibiotics are limited. Eradication treatment of this infection still raises important problems in medical practice. This study aims to compare the effectiveness of three eradication therapies used against H. pylori infection in the pediatric population. Methods: The prospective study enrolled children aged 6–17 years who were first diagnosed with H. pylori infection. Patients received a randomized treatment either the therapy with clarithromycin (CLR), the therapy with metronidazole (MTZ) or sequential therapy. The effectiveness of the eradication treatment was evaluated after 4–8 weeks from the end of the therapy by testing fecal antigen. Results: 149 patients were enrolled over 18 months. The eradication rates were 49.5% for the treatment scheme with proton pump inhibitor (PPI) + amoxicillin (AMO) + MTZ, 26.7% for PPI + AMO + CLR and 23.8% for sequential therapy. MTZ therapy was superior to CLR therapy, but sequential therapy was not. Side effects were recorded for PPI + AMO + CLR with 39.6%, followed by sequential therapy 37.7%, and only 22.6% for PPI + AMO + MTZ. Conclusions: Therapy with MTZ can achieve a higher eradication rate as a first-line treatment in the case of H. pylori infection. Taking into account that Romania is in an area with increased resistance to CLR, MTZ therapy could be a promising alternative.
ISSN:2227-9067
2227-9067
DOI:10.3390/children9091391