Nationwide survey of Helicobacter pylori treatment for children and adolescents in Japan

• Published in: Pediatrics international 2017-01, Vol.59 (1), p.57-61
• Main Authors: Okuda, Masumi, Kikuchi, Shogo, Mabe, Katsuhiro, Osaki, Takako, Kamiya, Shigeru, Fukuda, Yoshihiro, Kato, Mototsugu
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; adverse event; Amoxicillin; Amoxicillin - therapeutic use; Anemia, Iron-Deficiency - diagnosis; Anemia, Iron-Deficiency - drug therapy; Anemia, Iron-Deficiency - microbiology; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; antibiotic resistance; Antibiotics; Bacterial infections; Child; Children; Clarithromycin; Clarithromycin - therapeutic use; Drug Resistance, Bacterial; Drug Therapy, Combination; Duodenal Ulcer - diagnosis; Duodenal Ulcer - drug therapy; Duodenal Ulcer - microbiology; Eradication; Female; Gastric cancer; Gastritis; Gastritis - diagnosis; Gastritis - drug therapy; Gastritis - microbiology; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori; Helicobacter pylori - drug effects; Humans; Infections; Iron; Iron deficiency; Japan; Male; Medical personnel; Medical tests; Medical treatment; Metronidazole; Metronidazole - therapeutic use; Nutrient deficiency; Pathogens; Patients; Pediatrics; Polls & surveys; Practice Patterns, Physicians; Questionnaires; Retrospective Studies; Surveys and Questionnaires; Teenagers; treatment; Treatment Outcome
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.13038

Background To prevent gastric cancer, a test‐and‐treat strategy for Helicobacter pylori has been proposed. This retrospective study assessed the clinical features, efficacy and safety of treatment for H. pylori infection in children and adolescents. Methods Questionnaires concerning the clinical features and treatment of H. pylori in children and adolescents were sent to doctors in 2013. It included questions on patient background, H. pylori‐associated disease, first‐ and second‐line treatment, success or failure of eradication, resistance to antibiotics, and occurrence of adverse events. In 2014, serious adverse events associated with treatment were analyzed. Results Invitation letters and questionnaires were sent to 1097 doctors, of whom 409 (37.3%) participated. Finally, 332 patients (mean age, 11.6 ± 3.4 years; male, n = 200) treated from 1997 to 2013 were analyzed. H. pylori‐associated gastritis, iron deficiency anemia, and duodenal ulcer occurred most frequently. Success rates for first‐ and second‐line treatments were 73.1% and 79.6%, respectively. Seventy‐six H. pylori strains were analyzed for resistance to amoxicillin (AMPC) and clarithromycin (CAM), and 64 were analyzed for resistance to metronidazole (MNZ). CAM resistance was most frequent, occurring in 43.4% of patients; that of MNZ was 21.9%. Adverse events were observed in 13.8% of cases. In total, 587 cases of H. pylori infection were analyzed and no serious adverse events were observed. Conclusions Treatment for H. pylori in children and adolescents is safe, but further studies on treatment regimens should be conducted to improve eradication rates and monitor increasing CAM resistance.