title: Esomeprazole-based 1-week triple therapy directed by susceptibility testing for eradication of Helicobacter pylori infection in children.
abstract: BACKGROUND
  Poor compliance to therapy and antibiotic resistance are the main causes for failure of anti-Helicobacter pylori therapy.
  
  
  OBJECTIVE
  To evaluate the effectiveness of esomeprazole-based triple therapy directed by susceptibility testing.
  
  
  METHODS
  Symptomatic children with H. pylori infection, who underwent successful susceptibility testing and were colonized by no double-resistant strain, received 1-week triple therapy with esomeprazole, amoxicillin and either clarithromycin or metronidazole. Success of eradication was investigated by C-urea breath test.
  
  
  RESULTS
  Fifty-eight children (median age, 11.4 years; range, 2.2-17.7 years; 81% immigrants) were included. Helicobacter pylori was resistant to clarithromycin in 5 (9%) and to metronidazole in 9 children (16%). Eradication was successful in 49 (92%) of 53 children receiving esomeprazole, amoxicillin and clarithromycin and in all 5 children treated with metronidazole instead of clarithromycin, resulting in an eradication rate of 93% (95% confidence interval, 83%-98%, intention-to-treat analysis). All 4 treatment failures occurred in immigrants with language problems; 2 of them were obviously noncompliant.
  
  
  CONCLUSIONS
  Esomeprazole-based 1-week triple therapy directed by susceptibility testing is highly effective for eradication of H. pylori infection in children.
authors.affiliation: Dr von Haunersches Kinderspital of the Ludwig-Maximilians University of Munich, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Arenz
authors.forename: David
authors.initials: D
authors.lastname: Antos
authors.forename: Holger
authors.initials: H
authors.lastname: Rüssmann
authors.forename: Martin
authors.initials: M
authors.lastname: Alberer
authors.forename: Stefan
authors.initials: S
authors.lastname: Buderus
authors.forename: Matthias
authors.initials: M
authors.lastname: Kappler
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D010349:Patient Compliance; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin; D064098:Esomeprazole