Total family unit Helicobacter pylori eradication and pediatric re-infection rates.
BACKGROUND
Re-infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re-infection and if eradication of H. pylori from the entire family reduces the risk of childhood re-infection.


METHODS
Fifty families, each with an H. pylori-infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a 'family unit treatment' group (all infected family members treated) or an 'index case treatment' group (index case only treated).


RESULTS
At long-term follow-up (mean 62.2 months), there were three re-infected children in the 'index case treatment' group compared with one in the 'family unit treatment' group. The re-infection rate was 2.4% per patient per year in the 'index case treatment' group and 0.7% per patient per year in the 'family unit treatment' group (p = .31).


CONCLUSIONS
This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re-infection rates and reports the longest period of re-infection follow-up in children. In childhood, re-infection with H. pylori is not significantly reduced by family unit H. pylori eradication.
Department of Child Health, Institute of Clinical Science, Queen's University Belfast, UK. s.farrell@qub.ac.uk
Stephen
S
Farrell
Irene
I
Milliken
Gary M
GM
Doherty
Jane L
JL
Murphy
Steven A
SA
Wootton
William A
WA
McCallion
D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D017714:Community-Acquired Infections; D005192:Family Health; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D009853:Omeprazole / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D012008:Recurrence; D014508:Urea / Q000032:analysis
D009942:Organometallic Compounds; D008795:Metronidazole; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole