FAMILY TREATMENT OF SYMPTOMATIC CHILDREN WITH HELICOBACTER-PYLORI INFECTION

Background. Familial clustering of Helicobacter pylori infection has b een reported. We tested the hypothesis that simultaneously treating al l Helicobacter pylori positive family contacts of infected symptomatic children results in lower treatment failure. Methods: Relatives of 47 children (index) with Helicobacter pylori gastritis had endoscopy to assess prevalence of infection in first degree cohabiting relatives. C ontrols included 60 children with dyspepsia and Helicobacter pylori ga stritis whose infected family contacts were not treated. Index childre n, siblings younger than 18 years of age and control children received a 2-week course of amoxicillin and tinidazole. parents of index child ren and their siblings over 18 years of age received a 2-week course o f Colloidal Bismuth Subcytrate and tinidazole. The eradication rate in index children and their relatives was compared to controls whose inf ected family contacts were not treated. Results: Helicobacter pylori w as found in 67% of 31 siblings younger than 18, in 82% of 22 siblings older than 18 years, and in 87% of 92 parents. Endoscopy, repeated fou r to six weeks after the end of treatment, showed Helicobacter pylori eradication in 94% of children and siblings younger than 18, and in 70 % of parents and siblings over 18 years in the family treatment group, compared with 75% of control children (p<.01). Conclusions: The high prevalence of the infection in family members suggests that person-to- person spread of Helicobacter pylori takes place. Furthermore our resu lts show that if (or when) required, simultaneous treatment given to t he whole family results in lower treatment failure, since it may promo te compliance to treatment.