HELICOBACTER-PYLORI GASTRITIS AND NONULCER 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 we eks was assessed in children,vith Helicobacter pylori (H.pylori) gastr itis and non-ulcer dyspepsia, Twenty-six patients (group A) and 30 (gr oup B) had one-week and four-week schedule, respectively, Eradication (absence of organism at endoscopy at least 1 month after ending treatm ent) 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,vith eradicated H.pylori, symptoms improved significant ly in 14 and 16 patients of group A and B, respectively, but were stil l present in 17 (8 of group A, 9 group B), The latter showed gastropar esis 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 sym ptoms and H.pylori infection were unchanged, At 6 month follow-up, sym ptoms 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 conclud e that in children with dyspepsia and H.pylori gastritis one-week trip le antimicrobial schedule is effective in eradicating bacterium; howev er, detection of H.pylori gastritis in dyspeptic children does not inv ariably indicate a pathogenetic role of the organism in these patients .