Meta‐analysis: sequential therapy for Helicobacter pylori eradication in children

Abstract

SUMMARY BackgroundProblems with the standard triple treatment recommended for Helicobacter pylori eradication therapy include unsatisfactory (less than 80%) eradication rates among children.

Meta‐analysis: Is sequential therapy superior to standard triple therapy for Helicobacter pylori infection in Asian adults?

“…In a comparison of 14‐day STT, although there was a significant superiority forward SQT, since the lower limit of 95% CI for the RR was slightly above the one point zero (95% CI: 1.01–1.11), the clinical implication may not be guaranteed. Recent meta‐analysis about SQT for H. pylori eradication in children also reported that SQT was not superior to 10‐day and 14‐day STT in the efficacy, supporting our results. Because extending the duration of STT from 7 to 10–14 days improves the eradication rate by about 5%, if the difference in the eradication rate between SQT and STT is not so large, STT lasting more than 7 days might neutralize the superiority of SQT.…”

Optimization strategies aimed to increase the efficacy of H. pylori eradication therapies

“…[100][101][102][103][104][105][106][107][108][109] However, recent meta-analyses have shown that results are heterogeneous with suboptimal pooled cure rates (84%), nonsuperiority to 14-day triple therapy, and a tendency toward lower efficacy in the more recent studies. 4,100 However, early RCTs, included in several pooled-data analyses and meta-analyses, demonstrated that sequential regimen was more effective than standard triple therapy.…”

Eradication rate of Helicobacter Pylori infection is directly influenced by adherence to therapy in children

“…However, most parents (and children when old enough to understand) are willing to have a treatment, although there is no conclusive evidence, that eradication of the infection will improve their symptoms of dyspepsia. [11][12][13] It has been shown that the sequential treatment performs slightly better than a standard (not tailored to antimicrobial susceptibility) triple therapy given for only 7 days. 9,10 However, this goal is seldom obtained in most currently published trials in children.…”