ONE-WEEK TREATMENT WITH OMEPRAZOLE, CLARITHROMYCIN, AND METRONIDAZOLEIN CHILDREN WITH HELICOBACTER-PYLORI INFECTION

Background: The efficacy of a 1-week ''triple therapy'' in children wi th Helicobacter pylori gastritis and recurrent abdominal pain was stud ied. The effect of treatment was also studied in correlation to recurr ent abdominal pain. Methods: Thirty-two children with recurrent abdomi nal pain were investigated with H. pylori serology, C-13-urea breath t est, and endoscopy. Gastric biopsy specimens were analyzed with a rapi d urease test and histopathology. N. pylori-positive children were tre ated with omeprazole, clarithromycin, and metronidazole for 7 days. Th e same treatment was repeated for 2 weeks if a urea breath test produc ed positive results 1 month after the treatment period. If the test re sults were still positive after treatment, a second endoscopy was perf ormed with culture. Results: Twenty-eight (87.5%) children were urea b reath test-negative at follow-up 4 weeks (range, 4-15) after treatment . Another child became H. pylori-negative after a second treatment cou rse. Two of the three children who were still positive after the two t reatment periods, showed resistance to metronidazole and clarithromyci n. Conclusions: One-week therapy with omeprazole, clarithromycin and m etronidazole is an effective treatment in children with H. pylori infe ction. Bacterial resistance to clarithromycin and metronidazole must b e monitored if treatment fails.