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Updated: Jun 23, 2026
Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
Management of Helicobacter pylori infection in children
1Dipartimento di Scienze Mediche, Università di Torino, Italy.
Insights
Treating Helicobacter pylori infection in children can relieve symptoms and prevent future health issues. More research is needed to identify at-risk children and optimize treatment strategies for effective eradication.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori infection in children presents challenges in determining optimal treatment timing and patient selection.
- While eradication may prevent adult complications, robust studies identifying high-risk pediatric populations are lacking.
- Current pediatric treatment guidelines focus on eradication efficacy rather than risk stratification.
Purpose of the Study:
- To review current knowledge on Helicobacter pylori treatment in children.
- To highlight the importance of symptom remission and prevention of long-term complications.
- To identify gaps in research regarding risk assessment and treatment optimization in pediatric H. pylori infection.
Main Methods:
- Review of existing literature on Helicobacter pylori treatment regimens in pediatric populations.
- Analysis of factors influencing eradication rates, including drug combinations, treatment duration, and antibiotic resistance.
- Evaluation of diagnostic methods for confirming eradication post-treatment.
Main Results:
- Dual-drug therapies achieve 70-80% eradication in children when administered for at least two weeks.
- Antibiotic resistance is a concern that requires further study in pediatric H. pylori strains.
- Triple therapy has shown limited success in children due to poor compliance, similar to dual therapy outcomes.
Conclusions:
- Optimizing patient compliance through simple, short treatment regimens with rapid symptom relief is crucial for successful H. pylori eradication in children.
- Post-treatment confirmation of eradication is essential, utilizing methods like the 13C-ureabreath test (13C-UBT) with adjusted cut-offs.
- Further research is needed to identify children who would benefit most from treatment and to address antibiotic resistance patterns.
Abstract:
When trying to decide which children with Helicobacter pylori infection should be treated and at what stage they should be tested, we should take into account the fact that eradication of the infection may be useful both to induce symptom remission and to prevent later complications in adulthood. However, well designed studies to identify those infected children who are at risk of developing complications or have symptoms due to the infection are still lacking. Current literature only gives information on how to treat children with H pylori infection. Treatment regimens that include two drugs are usually more effective than in adults, and produce an eradication rate of 70-80%, but they should be given for at least two weeks, shorter treatments being less effective. Antibiotic resistance can impair eradication rate and the frequency of resistant strains in children should be studied. Combinations of antibiotics with antisecretory drugs are highly effective in adults, but triple therapy with two antibiotics and an antisecretory drug has been seldom tried in children; compliance is often poor so that the eradication rate is often similar to that produced by dual therapy. Compliance strongly influences eradication, and short simple treatment regimens that produce rapid symptom remission with few side effects are needed to optimise patient compliance. After treatment, eradication must be proved. Serological tests can help, provided that pretreatment serum is available and three to six months have passed since the treatment. A 13C-ureabreath test (13C-UBT) should be performed at least six weeks after treatment, but false negative results can occur and cut-off must be adjusted.
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