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Su DJ, Chang MH, Yang JC, et al. Fourteen-day sequential therapy is superior to 7-day triple therapy as first-line regimen for Helicobacter pylori infected children. J Formos Med Assoc. 2021;doi: 10.1016/j.jfma.2021.03.001.
Su, D. J., Chang, M. H., Yang, J. C., Ni, Y. H., Hsu, H. Y., & Wu, J. F. (2021). Fourteen-day sequential therapy is superior to 7-day triple therapy as first-line regimen for Helicobacter pylori infected children. Journal of the Formosan Medical Association = Taiwan yi zhi, . https://doi.org/10.1016/j.jfma.2021.03.001
Su, Da-Jyun, et al. "Fourteen-day sequential therapy is superior to 7-day triple therapy as first-line regimen for Helicobacter pylori infected children." Journal of the Formosan Medical Association = Taiwan yi zhi vol. (2021). doi: https://doi.org/10.1016/j.jfma.2021.03.001
Su DJ, Chang MH, Yang JC, Ni YH, Hsu HY, Wu JF. Fourteen-day sequential therapy is superior to 7-day triple therapy as first-line regimen for Helicobacter pylori infected children. J Formos Med Assoc. 2021 Mar 18; doi: 10.1016/j.jfma.2021.03.001. Epub 2021 Mar 18. PMID: 33745813.
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J Formos Med Assoc. 2021 Mar 18; doi: 10.1016/j.jfma.2021.03.001. Epub 2021 Mar 18.

Fourteen-day sequential therapy is superior to 7-day triple therapy as first-line regimen for Helicobacter pylori infected children.

Journal of the Formosan Medical Association = Taiwan yi zhi

Da-Jyun Su, Mei-Hwei Chang, Jyh-Chin Yang, Yen-Hsuan Ni, Hong-Yuan Hsu, Jia-Feng Wu

Affiliations

  1. Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Pediatrics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
  2. Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan.
  3. Department of Internal Medicine, Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
  4. Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan.
  5. Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan. Electronic address: [email protected].

PMID: 33745813 DOI: 10.1016/j.jfma.2021.03.001

Abstract

BACKGROUND/PURPOSE: Helicobacter pylori infection is one of the most common causes of peptic ulcer disease among children. This study is aimed to investigate the eradication rate of 14-day sequential therapy and the antibiotic resistance of H. pylori in children.

METHODS: Eighty-seven treatment-naïve children (55 males; median age, 13.5 years) with H. pylori infection from January 2009 to August 2019 were recruited in this study. The status of H. pylori infection was confirmed by culture or histology with the aid of urea rapid test or C-13 urea breathe test. Patients treated with either triple therapy for 7 days or 14 days, or sequential therapy for 14 days was analyzed retrospectively.

RESULTS: Thirty-eight (43.7%) patients received 14-day sequential therapy, 24 (27.6%) patients received 14-day triple therapy and the remaining 25 (28.7%) patients received 7-day triple therapy. The eradication rate of 14-day sequential therapy was significantly superior to 7-day triple therapy (97.4% vs. 80%, p = 0.032), and tended to be better than 14-day triple therapy (83%, p = 0.07). Of the 54 patients with available antibiotic resistance data, the resistant rate of clarithromycin, metronidazole, levofloxacin, and amoxicillin were 22.2%, 16.7%, 9.1% and 2.2%, respectively. Clarithromycin resistance demonstrated an inverse association with eradication success (Odds ratio = 0.017, p < 0.001).

CONCLUSIONS: In treatment-naïve children with H. pylori infection, 14-day sequential therapy is superior to triple therapy, and achieve a high eradication rate (above 90%) in an area of high clarithromycin resistance.

Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Keywords: Children; Eradication; Helicobacter pylori; Resistance; Sequential therapy

Conflict of interest statement

Declaration of competing interest The authors have no conflicts of interest relevant to this article.

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