Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 4, July-August, p. 701–708

doi: 10.17219/acem/38554

Publication type: original article

Language: English

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Assessment of Sequential and Standard Triple Therapy in Treatment of Helicobacter pylori Infection in Children Dependent on Bacteria Sensitivity to Antibiotics

Barbara M. Iwańczak1,A,C,D,E,F, Agnieszka Borys-Iwanicka1,A,B,C,D,E,F, Monika Biernat2,B,C,F, Grażyna Gościniak2,C,E,F

1 Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland

2 Department of Microbiology, Wroclaw Medical University, Poland

Abstract

Background. In the last decade a 10-day schema of sequential therapy of Helicobacter pylori infection based on proton pomp inhibitor (PPI), amoxicillin (AMO), clarithromycin (CLA) and metronidazole (MET) has been introduced. Many studies have emphasized greater efficacy of this therapy in comparison to the efficacy of the standard 7-day triple therapy (PPI + AMO + CLA or MET).
Objectives. The aim of the study was to assess the sequential and standard triple therapy.
Material and Methods. Sixty-nine children, aged 5 to 17 years, with symptoms of dyspepsia and gastric or duodenal ulcer were included in the study. The children were randomly divided into three groups. Group I – 23 children treated with PPI + AMO + CLA, group II – 23 children treated with PPI + AMO + MET, and group III – 23 children treated with sequential therapy. The diagnosis of Helicobacter pylori infection was based on histopathological evaluation of gastric mucosa sample and on culture. The sensitivity of bacterial strains to antibiotics was assessed based on E-tests. The efficacy of Helicobacter pylori eradication was assessed 6–8 weeks after the completion of the treatment.
Results. In children infected with Helicobacter pylori strains, which were sensitive to clarithromycin, the highest rate of eradication was obtained in the group treated with PPI + AMO + CLA (100%) and in the group treated with sequential therapy (90.48%), the lowest was in the group treated with PPI + AMO + MET.
Conclusion. Efficiency of treatment of Helicobacter pylori infection in children depended on sensitivity of the strains to clarithromycin. Sensitivity to metronidazole did not influence significantly the eradication rate.

Key words

Helicobacter pylori, resistance, sequential therapy, standard triple therapy

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