An Update on Anti-Helicobacter Pylori Treatment in Children

Previous consensus statements have recommended one- to two-week proton pump inhibitor (PPI)-based triple therapies with clarithromycin and either amoxicillin or metronidazole as first-line treatments for children with Helicobacter pylori infection. The objective of the present review was to summariz...

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Main Authors: Renuka Khurana, Lori Fischbach, Naoki Chiba, Sander Veldhuyzen van Zanten
Format: Article
Language:English
Published: Wiley 2005-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2005/289568
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author Renuka Khurana
Lori Fischbach
Naoki Chiba
Sander Veldhuyzen van Zanten
author_facet Renuka Khurana
Lori Fischbach
Naoki Chiba
Sander Veldhuyzen van Zanten
author_sort Renuka Khurana
collection DOAJ
description Previous consensus statements have recommended one- to two-week proton pump inhibitor (PPI)-based triple therapies with clarithromycin and either amoxicillin or metronidazole as first-line treatments for children with Helicobacter pylori infection. The objective of the present review was to summarize data from pediatric studies that have examined treatment efficacy, safety, drug resistance and reinfection rates related to anti-H pylori therapies. Data from a recent meta-analysis of pediatric studies were used along with the authors' existing databases and searches of individual studies. Regimens that were identified as greater than 80% efficacious in children included a two-week therapy with a nitroimidazole and amoxicillin in Europe; a two-week regimen of bismuth, amoxicillin and metronidazole in developed countries (except Spain); a one- to two-week regimen of a PPI, clarithromycin and amoxicillin in Northern Europe, Asia and the Middle East; and a two-week regimen of a PPI, clarithromycin and metronidazole in Canada. Although recommended as a first-line treatment in adults, two-week treatment with a PPI, clarithromycin and amoxicillin eradicated only 68% of H pylori infections in North American children. Treatment efficacy was reduced in the presence of metronidazole and/or clarithromycin resistance. Further studies of anti-H pylori treatments in children in North America and developing countries are warranted.
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spelling doaj-art-fc3a1c7b01184cda94f78a1899cbed9d2025-02-03T01:23:52ZengWileyCanadian Journal of Gastroenterology0835-79002005-01-0119744144510.1155/2005/289568An Update on Anti-Helicobacter Pylori Treatment in ChildrenRenuka Khurana0Lori Fischbach1Naoki Chiba2Sander Veldhuyzen van Zanten3Community Oriented Primary Care, Parkland Health and Hospital Systems, Dallas, USAUniversity of North Texas, School of Public Health, Fort Worth, Texas, USASurrey GI Clinic/Research, Guelph; and Division of Gastroenterology, McMaster University, Hamilton, Ontario, CanadaDivision of Gastroenterology, Dalhousie University, Halifax, Nova Scotia, CanadaPrevious consensus statements have recommended one- to two-week proton pump inhibitor (PPI)-based triple therapies with clarithromycin and either amoxicillin or metronidazole as first-line treatments for children with Helicobacter pylori infection. The objective of the present review was to summarize data from pediatric studies that have examined treatment efficacy, safety, drug resistance and reinfection rates related to anti-H pylori therapies. Data from a recent meta-analysis of pediatric studies were used along with the authors' existing databases and searches of individual studies. Regimens that were identified as greater than 80% efficacious in children included a two-week therapy with a nitroimidazole and amoxicillin in Europe; a two-week regimen of bismuth, amoxicillin and metronidazole in developed countries (except Spain); a one- to two-week regimen of a PPI, clarithromycin and amoxicillin in Northern Europe, Asia and the Middle East; and a two-week regimen of a PPI, clarithromycin and metronidazole in Canada. Although recommended as a first-line treatment in adults, two-week treatment with a PPI, clarithromycin and amoxicillin eradicated only 68% of H pylori infections in North American children. Treatment efficacy was reduced in the presence of metronidazole and/or clarithromycin resistance. Further studies of anti-H pylori treatments in children in North America and developing countries are warranted.http://dx.doi.org/10.1155/2005/289568
spellingShingle Renuka Khurana
Lori Fischbach
Naoki Chiba
Sander Veldhuyzen van Zanten
An Update on Anti-Helicobacter Pylori Treatment in Children
Canadian Journal of Gastroenterology
title An Update on Anti-Helicobacter Pylori Treatment in Children
title_full An Update on Anti-Helicobacter Pylori Treatment in Children
title_fullStr An Update on Anti-Helicobacter Pylori Treatment in Children
title_full_unstemmed An Update on Anti-Helicobacter Pylori Treatment in Children
title_short An Update on Anti-Helicobacter Pylori Treatment in Children
title_sort update on anti helicobacter pylori treatment in children
url http://dx.doi.org/10.1155/2005/289568
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