Helicobacter pylori gastritis and non-ulcer dyspepsia in childhood. Efficacy of one-week triple antimicrobial therapy in eradicating the organism.
Efficacy of one-week triple antimicrobial therapy (bismuth, tinidazole, amoxicillin) as compared to the same drug combination given for 4 weeks was assessed in children with Helicobacter pylori (H. pylori) gastritis and non-ulcer dyspepsia. Twenty-six patients (group A) and 30 (group B) had one-week and four-week schedule, respectively. Eradication (absence of organism at endoscopy at least 1 month after ending treatment) was achieved in 84.6% of group A (22) and 83.3% of group B (25), with marked reduction of histological gastritis score in both groups. Among patients with eradicated H. pylori, symptoms improved significantly in 14 and 16 patients of group A and B, respectively, but were still present in 17 (8 group A, 9 group B). The latter showed gastroparesis and abnormal gastro-oesophageal reflux at a subsequent diagnostic work-up and improved with prokinetic therapy. In 3 patients of group A and 3 of group B, symptoms improved despite persistence of bacterium into the stomach. Finally, in 3 cases (1 group A, 2 group B) both symptoms and H. pylori infection were unchanged. At 6 month follow-up, symptoms were present in 7 patients (3 group A, 4 group B): 6 of them (3 group A, 3 group B) showed H. pylori gastritis at endoscopy. We conclude that in children with dyspepsia and H. pylori gastritis one-week triple antimicrobial schedule is effective in eradicating bacterium; however, detection of H. pylori gastritis in dyspeptic children does not invariably indicate a pathogenic role of the organism in these patients.
Cucchiara
S
S
Dipartimento di Pediatria and Anatomia Patologica, Facoltà di Medicina, Università di Napoli Federico II, Italy.
Salvia
G
G
Az-Zeqeh
N
N
D'Armiento
F D
FD
De Petra
M R
MR
Rapagiolo
S
S
Campanozzi
A
A
Emiliano
M
M
D000293:Adolescent; D000465:Algorithms; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology*; D005500:Follow-Up Studies; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D009942:Organometallic Compounds / Q000627:therapeutic use; D013997:Time Factors; D014011:Tinidazole / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D009942:Organometallic Compounds; D014011:Tinidazole; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate; D001729:Bismuth