title: Nationwide survey of Helicobacter pylori treatment for children and adolescents in Japan.
abstract: BACKGROUND
  To prevent gastric cancer, a test-and-treat strategy for Helicobacter pylori has been proposed. This retrospective study assessed the clinical features, efficacy and safety of treatment for H. pylori infection in children and adolescents.
  
  
  METHODS
  Questionnaires concerning the clinical features and treatment of H. pylori in children and adolescents were sent to doctors in 2013. It included questions on patient background, H. pylori-associated disease, first- and second-line treatment, success or failure of eradication, resistance to antibiotics, and occurrence of adverse events. In 2014, serious adverse events associated with treatment were analyzed.
  
  
  RESULTS
  Invitation letters and questionnaires were sent to 1097 doctors, of whom 409 (37.3%) participated. Finally, 332 patients (mean age, 11.6 ± 3.4 years; male, n = 200) treated from 1997 to 2013 were analyzed. H. pylori-associated gastritis, iron deficiency anemia, and duodenal ulcer occurred most frequently. Success rates for first- and second-line treatments were 73.1% and 79.6%, respectively. Seventy-six H. pylori strains were analyzed for resistance to amoxicillin (AMPC) and clarithromycin (CAM), and 64 were analyzed for resistance to metronidazole (MNZ). CAM resistance was most frequent, occurring in 43.4% of patients; that of MNZ was 21.9%. Adverse events were observed in 13.8% of cases. In total, 587 cases of H. pylori infection were analyzed and no serious adverse events were observed.
  
  
  CONCLUSIONS
  Treatment for H. pylori in children and adolescents is safe, but further studies on treatment regimens should be conducted to improve eradication rates and monitor increasing CAM resistance.
authors.affiliation: Department of General Medicine and Community Health Science, Hyogo College of Medicine, Sasayama, Japan.
authors.forename: Masumi
authors.initials: M
authors.lastname: Okuda
authors.affiliation: Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kikuchi
authors.affiliation: Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Hokkaido, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mabe
authors.affiliation: Department of Infectious Diseases, Kyorin University School of Medicine, Mitaka, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Osaki
authors.affiliation: Department of Infectious Diseases, Kyorin University School of Medicine, Mitaka, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kamiya
authors.affiliation: Department of Gastroenterology, Kyowakai Medical Corporation Second Kyoritsu Hospital, Kawanishi, Hyogo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Hokkaido, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007564:Japan; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
keywords: 
  Helicobacter pylori
  ; adverse event; antibiotic resistance; treatment