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

Research output: Contribution to journalArticlepeer-review

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

ASJC Scopus subject areas

  • Gastroenterology

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