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Updated: May 24, 2026

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Review article: bismuth-based therapy for Helicobacter pylori eradication in children
L Pacifico1, J F Osborn, C Anania
1Department of Pediatrics, Sapienza University of Rome, Rome, Italy.
Bismuth-based therapies show moderate Helicobacter pylori eradication rates in children, but more research is needed. Further studies are required to confirm efficacy and safety for H. pylori eradication in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Standard triple therapy for H. pylori eradication in children shows declining efficacy.
- Bismuth-based therapy is emerging as an alternative first-line treatment for pediatric H. pylori infections.
Purpose of the Study:
- To review the properties of bismuth salts.
- To summarize evidence on bismuth-based therapy for H. pylori eradication in children.
Main Methods:
- Bibliographical searches conducted in MEDLINE.
- Meta-analysis of efficacy data for bismuth-containing regimens.
Main Results:
- Bismuth monotherapy demonstrated low efficacy.
- Bismuth-based dual therapy achieved 68-73% eradication rates (ITT/PP).
- Triple therapy with bismuth showed 82-86% eradication rates (ITT/PP), with comparative studies ranging from 69-96%.
Conclusions:
- Evidence for bismuth compounds in pediatric H. pylori treatment is inconclusive.
- Need for well-designed, multi-center randomized trials comparing bismuth-based triple therapy with current standards.
- Audited case series with >95% eradication rates (PP) warrant consideration.
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