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Family treatment of symptomatic children with Helicobacter pylori infection
G Oderda1, A Ponzetto, M Boero
1Paediatric Gastroenterology Unit, University of Turin, Italy.
Insights
Simultaneously treating Helicobacter pylori positive family members of infected children improves eradication rates. Family-wide treatment of H. pylori reduces treatment failure and promotes compliance.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Public Health
Background:
- Familial clustering of Helicobacter pylori infection is recognized.
- This study investigated the impact of family-wide treatment on H. pylori eradication.
- H. pylori infection is a significant cause of gastritis.
Purpose of the Study:
- To test the hypothesis that simultaneous treatment of all H. pylori positive family contacts of infected children leads to lower treatment failure.
- To assess the prevalence of H. pylori infection among family members of infected children.
- To compare eradication rates in a family treatment group versus a control group.
Main Methods:
- Endoscopic assessment of H. pylori infection in relatives of 47 index children.
- Control group: 60 children with H. pylori gastritis and untreated infected family contacts.
- Treatment regimens varied by age, including amoxicillin, tinidazole, and colloidal bismuth subcitrate.
Main Results:
- H. pylori prevalence was high in siblings (67-82%) and parents (87%).
- Eradication rates were 94% in children/younger siblings and 70% in parents/older siblings in the family treatment group.
- Control children achieved a 75% eradication rate (p < .01).
Conclusions:
- High H. pylori prevalence in families suggests person-to-person transmission.
- Simultaneous family treatment significantly lowers H. pylori treatment failure rates.
- Family-wide treatment may enhance patient compliance, improving outcomes.
Background:
Familial clustering of Helicobacter pylori infection has been reported. We tested the hypothesis that simultaneously treating all Helicobacter pylori positive family contacts of infected symptomatic children results in lower treatment failure.
Methods:
Relatives of 47 children (index) with Helicobacter pylori gastritis had endoscopy to assess prevalence of infection in first degree cohabiting relatives. Controls included 60 children with dyspepsia and Helicobacter pylori gastritis whose infected family contacts were not treated. Index children, siblings younger than 18 years of age and control children received a 2-week course of amoxicillin and tinidazole. Parents of index children and their siblings over 18 years of age received a 2-week course of Colloidal Bismuth Subcytrate and tinidazole. The eradication rate in index children and their relatives was compared to controls whose infected family contacts were not treated.
Results:
Helicobacter pylori was found in 67% of 31 siblings younger than 18, in 82% of 22 siblings older than 18 years, and in 87% of 92 parents. Endoscopy, repeated four to six weeks after the end of treatment, showed Helicobacter pylori eradication in 94% of children and siblings younger than 18, and in 70% of parents and siblings over 18 years in the family treatment group, compared with 75% of control children (p < .01).
Conclusions:
The high prevalence of the infection in family members suggests that person-to-person spread of Helicobacter pylori takes place. Furthermore our results show that if (or when) required, simultaneous treatment given to the whole family results in lower treatment failure, since it may promote compliance to treatment.