Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children: A randomized trial

Ruggiero Francavilla, Elena Lionetti, Stefania Paola Castellaneta, Anna Maria Magistà, Giuseppe Boscarelli, Domenico Piscitelli, Annacinzia Amoruso, Alfredo Di Leo, Vito Leonardo Miniello, Antonio Francavilla, Luciano Cavallo, Enzo Ierardi

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Abstract

Background & Aims: The currently recommended first-line eradication treatment of Helicobacter pylori in children is usually successful in about 75%. Recently, in adults, a novel 10-day sequential treatment has achieved an eradication rate of 95%. The aim of the study was to assess the H pylori eradication rate of the sequential treatment regimen compared with conventional triple therapy in children. Methods: Seventy-eight consecutive children with H pylori infection were randomized to receive either sequential treatment (omeprazole plus amoxicillin for 5 days, followed by omeprazole plus clarithromycin plus tinidazole for another 5 days) (n = 38; 15 boys [39.5%]; median age, 11.0 years [range, 3.3-16 years]) or triple therapy (omeprazole, amoxicillin, and metronidazole) for 1 week (n = 37; 15 boys [40.5%]; median age, 9.9 years [range, 4.3-16 years]). H pylori infection was based on 2 out of 3 positive tests results: 13C-urea breath test, rapid urease test, and histologic analysis. Eradication was assessed by 13C-urea breath test 8 weeks after therapy. Results: Seventy-four patients completed the study. H pylori eradication was achieved in 36 children receiving sequential treatment (97.3%; 95% confidence interval, 86.2-99.5) and 28 children receiving triple therapy (75.7%; 95% confidence interval, 59.8-86.7) (P <.02). Compliance with therapy was good (>95%) in all. Conclusions: Our study shows, for the first time in children, that 10-day sequential treatment achieves a higher eradication rate than standard triple therapy, which is consistent with the results of adult studies.

Original languageEnglish
Pages (from-to)1414-1419
Number of pages6
JournalGastroenterology
Volume129
Issue number5
DOIs
Publication statusPublished - Nov 2005

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Helicobacter pylori
Pylorus
Omeprazole
Therapeutics
Breath Tests
Amoxicillin
Urea
Tinidazole
Confidence Intervals
Clarithromycin
Urease
Metronidazole
Infection

ASJC Scopus subject areas

  • Gastroenterology

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Francavilla, R., Lionetti, E., Castellaneta, S. P., Magistà, A. M., Boscarelli, G., Piscitelli, D., ... Ierardi, E. (2005). Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children: A randomized trial. Gastroenterology, 129(5), 1414-1419. https://doi.org/10.1053/j.gastro.2005.09.007

Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children : A randomized trial. / Francavilla, Ruggiero; Lionetti, Elena; Castellaneta, Stefania Paola; Magistà, Anna Maria; Boscarelli, Giuseppe; Piscitelli, Domenico; Amoruso, Annacinzia; Di Leo, Alfredo; Miniello, Vito Leonardo; Francavilla, Antonio; Cavallo, Luciano; Ierardi, Enzo.

In: Gastroenterology, Vol. 129, No. 5, 11.2005, p. 1414-1419.

Research output: Contribution to journalArticle

Francavilla, R, Lionetti, E, Castellaneta, SP, Magistà, AM, Boscarelli, G, Piscitelli, D, Amoruso, A, Di Leo, A, Miniello, VL, Francavilla, A, Cavallo, L & Ierardi, E 2005, 'Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children: A randomized trial', Gastroenterology, vol. 129, no. 5, pp. 1414-1419. https://doi.org/10.1053/j.gastro.2005.09.007
Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Boscarelli G, Piscitelli D et al. Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children: A randomized trial. Gastroenterology. 2005 Nov;129(5):1414-1419. https://doi.org/10.1053/j.gastro.2005.09.007
Francavilla, Ruggiero ; Lionetti, Elena ; Castellaneta, Stefania Paola ; Magistà, Anna Maria ; Boscarelli, Giuseppe ; Piscitelli, Domenico ; Amoruso, Annacinzia ; Di Leo, Alfredo ; Miniello, Vito Leonardo ; Francavilla, Antonio ; Cavallo, Luciano ; Ierardi, Enzo. / Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children : A randomized trial. In: Gastroenterology. 2005 ; Vol. 129, No. 5. pp. 1414-1419.
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AU - Lionetti, Elena

AU - Castellaneta, Stefania Paola

AU - Magistà, Anna Maria

AU - Boscarelli, Giuseppe

AU - Piscitelli, Domenico

AU - Amoruso, Annacinzia

AU - Di Leo, Alfredo

AU - Miniello, Vito Leonardo

AU - Francavilla, Antonio

AU - Cavallo, Luciano

AU - Ierardi, Enzo

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N2 - Background & Aims: The currently recommended first-line eradication treatment of Helicobacter pylori in children is usually successful in about 75%. Recently, in adults, a novel 10-day sequential treatment has achieved an eradication rate of 95%. The aim of the study was to assess the H pylori eradication rate of the sequential treatment regimen compared with conventional triple therapy in children. Methods: Seventy-eight consecutive children with H pylori infection were randomized to receive either sequential treatment (omeprazole plus amoxicillin for 5 days, followed by omeprazole plus clarithromycin plus tinidazole for another 5 days) (n = 38; 15 boys [39.5%]; median age, 11.0 years [range, 3.3-16 years]) or triple therapy (omeprazole, amoxicillin, and metronidazole) for 1 week (n = 37; 15 boys [40.5%]; median age, 9.9 years [range, 4.3-16 years]). H pylori infection was based on 2 out of 3 positive tests results: 13C-urea breath test, rapid urease test, and histologic analysis. Eradication was assessed by 13C-urea breath test 8 weeks after therapy. Results: Seventy-four patients completed the study. H pylori eradication was achieved in 36 children receiving sequential treatment (97.3%; 95% confidence interval, 86.2-99.5) and 28 children receiving triple therapy (75.7%; 95% confidence interval, 59.8-86.7) (P <.02). Compliance with therapy was good (>95%) in all. Conclusions: Our study shows, for the first time in children, that 10-day sequential treatment achieves a higher eradication rate than standard triple therapy, which is consistent with the results of adult studies.

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