Omeprazole-based Dual and Triple Regimens for<i>Helicobacter pylori</i>Eradication in Children

Kato, Seiichi; Takeyama, Junji; Ebina, Kyoko; Naganuma, Hiroshi

doi:10.1542/peds.100.1.e3

Cited by 57 publications

(57 citation statements)

References 23 publications

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“…The patients must be advised to continue the treatment even if these symptoms occur. KATO et al (12) noted a high eradication rate (92%) using CAO therapy for Hp ulcer disease and nodular gastritis in a smaller sample (12 children), but our result was similar to other two studies using CAO therapy: in 32 Swedish children for 2 weeks (75%) (29) and in 45 Italian children (78%) (20) . A long-term study is important to determine the effect of Hp eradication on remission or recurrence of symptoms in children with Hp positive gastritis without peptic ulcer.…”

Section: Discussionsupporting

confidence: 89%

“…The problems associated with poor compliance, such as treatment failure, development of drug resistance and the expenses and inconvenience of further investigation and therapy, make it imperative to find a short course, highly effective and well tolerated regimen. Side effects, a factor contributing to non-compliance, occurred in only two patients (8%), less than that reported by KATO et al (12) (33%). Clarithromycin can cause metallic taste, nausea, vomiting or diarrhea.…”

Section: Discussioncontrasting

confidence: 58%

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Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

Kawakami

Ogata

Portorreal

et al. 2001

Arq. Gastroenterol.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 58%

Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

Kawakami

Ogata

Portorreal

et al. 2001

Arq. Gastroenterol.

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“…The most commonly tested regimen contained a combination of PPI, clarithromycin, and amoxicillin, followed by triple therapies containing PPI, clarithromycin, and nitroimidazoles, or bismuth, clarithromycin, and nitroimidazoles (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The reasons for the great variability of the eradication rates observed in the studies include small sizes of study populations, differences between study populations, and variation in the total daily dose, dosing frequency and duration of treatment components, as well as in time of posttreatment follow-up and methods used to assess eradication after treatment.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, this method provides no information on dose timing, which may be important in determining clinical outcomes. In other pediatric studies indirect methods of measurement of adherence included questioning the patient (or using a questionnaire) (4,7,15), but questioning the patient can be susceptible to misrepresentation and tends to result in the physician's overestimating the patient's adherence. This underscores the thought that the body of knowledge on children's adherence to medication regimens (or placebo) for H. pylori eradication is inadequate in many respects and has not quantified the true effect of nonadherence on the failure rates of various medication regimens.…”

Section: Factors Affecting Eradication Ratementioning

confidence: 99%

Helicobacter Pylori Therapy in Children: Overview and Challenges

Chiesa

Pacifico

Anania

et al. 2010

Int J Immunopathol Pharmacol

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Helicobacter pylori is one of the most common infections found in humans. It was first identified in 1982 and by 1989 had been associated with gastric inflammation and ulcers in adults and children. During the 1990's evidence emerged of its etiologic role in stomach cancers in adults. That the infection is common and may have serious consequences, has led to an avalanche of research during the last twenty years. During this time, there have been many studies on children which have sought an effective and safe treatment to eradicate the infection, but as yet, no therapy regimen has been found which is always effective and safe. This article provides information, from a pediatric point of view, on the major developments in the therapeutics and therapy of H. pylori infection. It examines first-line treatment regimens, evaluates the efficacy of the main drugs used in the management of (primary) H. pylori infection in children, assesses the potential for the use of probiotics and sequential therapy, examines therapeutic options after failure of initial treatment, and discusses factors affecting eradication rate, including antibiotic resistance, adherence to therapy, and bacterial factors.

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“…The diagnoses included gastritis (n ϭ 27), gastric ulcer (n ϭ 2), and duodenal ulcer (n ϭ 19). Among these patients, 42 patients had no prior history of eradication therapy; 36 patients received a 7-to 14-day course of a PPI, omeprazole or lansoprazole, plus amoxicillin and clarithromycin as the first-line therapy (18,19). Three patients in whom eradication was unsuccessful during the period of the study and six patients with previous histories of eradication failure with amoxicillin and clarithromycin treatment received second-line therapy with a PPI and amoxicillin plus metronidazole (n ϭ 6) or minocycline (n ϭ 3); H. pylori was isolated from all nine patients before the start of the second-line therapy.…”

mentioning

confidence: 99%

Antibiotic Resistance of Helicobacter pylori Strains in Japanese Children

et al. 2002

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The resistance of Helicobacter pylori to the recently available antibiotic treatment regimens has been a growing problem. We investigated the prevalence of H. pylori resistance to clarithromycin, metronidazole, and amoxicillin among 51 H. pylori isolates from Japanese children. In addition, the mutations of the corresponding gene were studied by PCR and restriction fragment length polymorphism analysis. Primary resistance to clarithromycin, metronidazole, and amoxicillin was detected in 29, 24, and 0% of strains, respectively. The eradication rates in clarithromycin-susceptible and -resistant strains were 89 and 56%, respectively (P < 0.05). The prevalence of strains with acquired resistance to clarithromycin (78%) was higher than that of strains with primary resistance (P < 0.01). Among the clarithromycin-resistant strains studied, 92% showed cross-resistance to azithromycin. No acquired resistance to amoxicillin was demonstrated. The A2144G mutation in the 23S rRNA gene was detected in 11 of 12 (92%) clarithromycin-resistant strains tested, whereas the mutation was not detected in any of the 15 susceptible strains. The deletion of the rdxA gene was not demonstrated in any of the strains. The results indicate that a high prevalence of clarithromycin-resistant strains is associated with eradication failure. Testing of susceptibility to clarithromycin is recommended.In adults, Helicobacter pylori plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, and possibly, gastric carcinoma. H. pylori infection is also associated with chronic gastritis and duodenal ulcer in children (5, 13). Eradication of the organism not only accelarates ulcer healing (14) but also prevents long-term ulcer relapse (12). Recently, proton pump inhibitor (PPI)-based eradication regimens containing two antibiotics have been demonstrated to have high eradication rates (greater than 90%) (3, 22). Amoxicillin, clarithromycin, and metronidazole are the most frequently used antibiotics for the treatment of H. pylori infection. However, antibiotic resistance frequently causes failure of eradication of H. pylori (1,16,21). The resistance of H. pylori to the recently available antibiotic treatment regimens has been a growing problem. In developed countries, metronidazole resistance is found in 10 to 50% of adult patients infected with H. pylori (1, 10, 11), whereas virtually all strains are resistant to the agent in developing countries (26). On the other hand, although the rates of clarithromycin resistance are relatively low, ranging from 2 to 15% (1, 2, 10, 11, 27), the rate of clarithromycin resistance has been increasing during recent years.With regard to antibiotic resistance, however, there have been few reports of antibiotic resistance in children 2, 17, 23; M. Lopez-Brea, M. Martinez, D. Domingo, and T. Alarcon, abstract from the XIII International Workshop on Gastroduodenal Pathology and Helicobacter pylori, Gut 47(Suppl. 1): A95, 2000], and its clinical significance remains to be established. The purpose ...

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Omeprazole-based Dual and Triple Regimens forHelicobacter pyloriEradication in Children

Abstract: An omeprazole-based regimen is safe and may be a better option for eradication of H pylori in children. Antral nodularity is a macroscopic marker of H pylori infection.

Cited by 57 publications

References 23 publications

Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

Helicobacter Pylori Therapy in Children: Overview and Challenges

Antibiotic Resistance of Helicobacter pylori Strains in Japanese Children

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