Safety and efficacy of one-week triple therapy for eradicating Helicobacter pylori in children

Background. Proton pump inhibitor-based eradication therapy of Helicobacter pylori has been widely studied in adults, but there have been only a few r eports about this therapy in children. The purpose of this study was to inv estigate the safety and efficacy of 1-week triple therapy for eradication o f H. pylori and ulcer healing in children. Patients and Methods. We prospectively studied 15 patients aged 2-17 years (5 with gastric ulcers, 8 with duodenal ulcers, and 2 with nodular gastriti s alone). Three patients had H2 blocker-resistant duodenal ulcers. Patients received 0.75 mg/kg of lansoprazole b.i.d., 25 mg/kg of amoxicillin b.i.d. , and 10 mg/kg of clarithromycin b.i.d. for 7 days. No additional therapy ( including antisecretory drugs) was administered to any patients following e radication therapy. Patients underwent endoscopy to obtain antral biopsies (culture, urease test and histology) and to evaluate the mucosal status, an d underwent a C-13-urea breath test before and 4-8 weeks after the completi on of a 1-week course of therapy. Results. All patients received the full drug regimen. Endoscopy showed comp lete healing of ulcers in 12 of 13 patients with peptic ulcer disease (92%) . H. pylori was eradicated in 13 of 15 patients (87%). Diarrhea and/or an a ltered taste sensation occurred in 5 patients (33%). There were no hematolo gical or biochemical abnormalities related to therapy. Conclusion. The 1-week triple therapy was safe and effective for eradicatin g H. pylori. The present study showed that ulcer healing in juveniles is cl osely associated with eradication of H. pylori, and that no additional ther apy is required when H. pylori is eradicated. A shorter course of eradicati on therapy than 2 weeks may be suitable for children with H. pylori infecti on.