Details

Autor(en) / Beteiligte

• Schwarzer, A
• Urruzuno, P
• Iwańczak, B
• Martínez‐Gómez, MZ
• Kalach, N
• Roma‐Giannikou, E
• Liptay, S
• Bontem, P
• Buderus, S
• Wenzl, TG
• Koletzko, S

Titel

New Effective Treatment Regimen for Children Infected With a Double‐resistant Helicobacter pylori Strain

Ist Teil von

• Journal of pediatric gastroenterology and nutrition, 2011-04, Vol.52 (4), p.424-428

Ort / Verlag

Hagerstown, MD: Copyright by ESPGHAN and NASPGHAN

Erscheinungsjahr

2011

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• ABSTRACT Background: The increasing number of pediatric patients infected with multiresistant Helicobacter pylori strains calls for evaluation of treatment regimens. Second‐line antibiotics such as tetracycline or quinolones are not licensed for children. Because in vivo resistance to metronidazole may be overcome in vivo by a high dose and prolonged intake, we evaluated the eradication rate and side effects of a high‐dose triple therapy in pediatric patients with culture‐proven double resistance. Patients and Methods: In this open multicentre trial, 62 children (<18 years, body weight >15 kg) infected with an H pylori strain resistant to metronidazole and clarithromycin were treated according to body weight classes with amoxicillin (∼75 mg/kg/day), metronidazole (∼25 mg/kg/day) and esomeprazole (∼1.5 mg/kg/day) for 2 weeks. Adherence and adverse events were assessed by a 2‐week diary and telephone interviews at days 7 and 14 of treatment. Primary outcome was a negative 13C‐urea breath test after 6 weeks. Results: Of 62 patients, 5 were lost to follow‐up, 12 were nonadherent, and 45 treated per protocol. Eradication rates were 66% (41/62) [confidence interval 54–78] (intention to treat) and 73% (33/45) [confidence interval 60–86] (per protocol). Success of treatment was not related to dose per kilogram body weight. Mild to moderate adverse events were reported by 21 patients, including nausea (10.8%), diarrhoea (8.9%), vomiting (7.1%), abdominal pain (5.4%), and headache (3.6%), and led to discontinuation in 1 child. Conclusion: High‐dose amoxicillin, metronidazole, and esomeprazole for 2 weeks is a good treatment option in children infected with a double resistant H pylori strain.