Meta‐analysis: Helicobacter pylori eradication treatment efficacy in children

Summary Background  Several meta‐analyses assessing the efficacy of anti‐Helicobacter pylori treatment in adults have been published but a comparable meta‐analysis in children is lacking. Aims  To summarize the efficacy of treatments aimed at eradicating H. pylori in children and to identify sources...

Full description

Saved in:
Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2007-03, Vol.25 (5), p.523-536
Main Authors: KHURANA, R., FISCHBACH, L., CHIBA, N., VAN ZANTEN, S. V., SHERMAN, P. M., GEORGE, B. A., GOODMAN, K. J., GOLD, B. D.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Drug Therapy, Combination
Helicobacter Infections - drug therapy
Helicobacter pylori
Helicobacter pylori - drug effects
Humans
Infant
Infant, Newborn
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Background  Several meta‐analyses assessing the efficacy of anti‐Helicobacter pylori treatment in adults have been published but a comparable meta‐analysis in children is lacking. Aims  To summarize the efficacy of treatments aimed at eradicating H. pylori in children and to identify sources of variation in treatment efficacy across studies. Methods  We searched Medline, reference lists from published study reports, and conference proceedings for anti‐H. pylori treatment trials in children. Weighted meta‐regression models were used to find sources of variation in efficacy. Results  Eighty studies (127 treatment arms) with 4436 children were included. Overall, methodological quality of these studies was poor with small sample sizes and few randomized‐controlled trials. The efficacy of therapies varied across treatment arms, treatment duration, method of post‐treatment assessment and geographic location. Among the regimens tested, 2–6 weeks of nitroimidazole and amoxicillin, 1–2 weeks of clarithromycin, amoxicillin and a proton pump inhibitor, and 2 weeks of a macrolide, a nitroimidazole and a proton pump inhibitor or bismuth, amoxicillin and metronidazole were the most efficacious in developed countries. Conclusions  Before worldwide treatment recommendations are given for eradication of H. pylori, additional well‐designed randomized placebo‐controlled paediatric trials are needed, especially in developing countries where both drug resistance and disease burden is high.
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2006.03236.x