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Omeprazole-based dual and triple regimens for Helicobacter pylori eradication in children
1Department of Pediatrics, Sendai City Hospital, Sendai, Japan.
Insights
Omeprazole-based dual and triple regimens effectively treated Helicobacter pylori infection in children. The triple regimen showed higher eradication rates (92%) and improved gastritis scores, indicating a safe and effective treatment option.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Helicobacter pylori infection is a common cause of gastrointestinal issues in children, including ulcers and gastritis.
- Effective eradication therapies are crucial to prevent long-term complications.
Purpose of the Study:
- To assess the efficacy and safety of omeprazole-based dual and triple therapy regimens for treating Helicobacter pylori infection in pediatric patients.
- To evaluate the impact of successful eradication on gastritis and antibody titers.
Main Methods:
- A study involving 22 children with H. pylori infection, randomized into omeprazole-amoxicillin dual therapy (n=10) or omeprazole-amoxicillin-clarithromycin triple therapy (n=12).
- Treatment duration was 2 weeks, with extended omeprazole for active ulcers. Endoscopic biopsies and serum antibody titers were analyzed before and after treatment.
- Gastritis scores and antral nodularity were assessed as indicators of infection and treatment success.
Main Results:
- The triple regimen achieved a higher H. pylori eradication rate (92%) compared to the dual regimen (70%).
- Successful eradication significantly reduced gastritis scores and serum anti-H. pylori IgG antibody titers.
- Active ulcers healed within 6 weeks, and antral nodularity often resolved with successful treatment. Mild side effects were reported in 23% of patients.
Conclusions:
- Omeprazole-based regimens are safe and effective for H. pylori eradication in children.
- The triple therapy regimen demonstrated superior efficacy.
- Antral nodularity can serve as a visible indicator of H. pylori infection.
Objective:
To evaluate the efficacy and safety of omeprazole-based dual and triple regimens for the treatment of children with Helicobacter pylori infection.
Methods:
Twenty-two patients (3 with gastric ulcer, 12 with duodenal ulcer, and 7 with nodular gastritis alone) were studied. Twelve ulcer patients also had nodular gastritis. The dual regimen included a 2-week course of omeprazole (0.6 mg/kg twice a day) and amoxicillin (30 mg/kg twice a day) (n = 10), and the triple regimen included the dual regimen plus clarithromycin (15 mg/kg twice a day) (n = 12). In patients with active ulcers, omeprazole once daily was administered for another 4 weeks. Endoscopic biopsies were taken before therapy and 4 weeks after completion of a 2-week course of therapy, and patients were followed for 6 months. The gastritis score (grade 0 to 3) and serum anti-H pylori IgG antibody titers were also determined.
Results:
The regimens were tolerated by all patients. Eradication rates for the dual and triple regimens were 70% and 92%, respectively. Active ulcers completely healed within 6 weeks. Patients with nodular gastritis alone showed different clinical responses to therapy. Pretreatment histology showed chronic gastritis in all patients. Successful H pylori eradication significantly reduced the mean gastritis score from 2.9 to 1.3, but unsuccessful eradication did not reduce it. The disappearance of antral nodularity often coincided with the success of eradication. Successful eradication significantly decreased pretreatment serum anti-H pylori IgG antibody titers by 29% at 1 month, by 52% at 3 months, and by 67% at 6 months. Side effects were mild and were reported in 23% of patients.
Conclusion:
An omeprazole-based regimen is safe and may be a better option for eradication of H pylori in children. Antral nodularity is a macroscopic marker of H pylori infection.