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Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Diagnostic and Treatment Practices for Helicobacter Pylori Infection in an Academic Pediatric Hospital
Muhammad Safwan Riaz1, Steven F Moss2, Jason M Shapiro3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, The University of Oklahoma Health Sciences Center, The Children's Hospital at OU Medicine, Oklahoma City, Oklahoma.
Insights
Pediatric Helicobacter pylori (H. pylori) treatment regimens showed similar, suboptimal eradication rates. Antibiotic susceptibility testing is crucial for effective H. pylori infection management in children and adolescents.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Revised guidelines in 2016 by ESPGHAN/NASPGHAN emphasized antibiotic susceptibility testing for pediatric H. pylori management.
- Current H. pylori treatment strategies in pediatric populations require evaluation.
Purpose of the Study:
- To assess the H. pylori treatment landscape and outcomes in pediatric patients.
- To analyze trends in antibiotic prescriptions and eradication rates before and after 2016.
Main Methods:
- Retrospective analysis of pediatric H. pylori patients (2015-2021) at an academic children's hospital.
- Calculated frequency of treatment regimens and their eradication rates.
- Compared prescription and eradication trends pre- and post-2016.
Main Results:
- 196 pediatric patients were included in the study.
- Amoxicillin, clarithromycin, and PPI triple therapy was most common (46.5%), followed by amoxicillin, metronidazole, and PPI (33%).
- Eradication rates were 70% for clarithromycin-based therapy and 64% for metronidazole-based therapy.
Conclusions:
- Both common H. pylori treatment regimens demonstrated comparable but suboptimal eradication rates in pediatric patients.
- The findings underscore the necessity of integrating antibiotic resistance testing into clinical practice for improved H. pylori treatment outcomes.
- Tailoring H. pylori therapy based on susceptibility testing is recommended for children and adolescents.
Background:
In 2016, ESPGHAN/NASPGHAN issued revised guidelines for the management of Helicobacter pylori (H. pylori) infection in children and adolescents. Recommendations include performing antibiotic susceptibility testing to tailor therapy. The aim of our study was to evaluate the H. pylori treatment landscape in pediatric patients at our institution.
Methods:
We performed a retrospective study of patients diagnosed with H. pylori infection at a single academic children's hospital from 2015 to 2021. The frequency of each treatment regimen and their respective eradication rates were calculated. We compared trends in antibiotic prescriptions and eradication rates before and after 2016.
Results:
One hundred and ninety-six patients were included. Triple therapy with amoxicillin, clarithromycin, and a proton pump inhibiter (PPI) was the most often prescribed regimen (46.5%), followed by amoxicillin, metronidazole, and PPI (33%). Eradication rates were 70% for amoxicillin, clarithromycin, and PPI and 64% for amoxicillin, metronidazole, and PPI.
Conclusion:
Our results show eradication rates for both regimens were comparable but suboptimal, highlighting the need to incorporate resistance testing into broader practice.
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