Efficacy of bismuth-based triple therapy in children with abdominal pain and Helicobacter pylori gastritis

Background: To evaluate the effect of a therapeutic regimen of 7 days versu s 14 days on the clinical manifestations of Helicobacter pylori gastritis i n children. Methods: Ninety children (age 2-19 years) who had abdominal pain and/or rec urrent vomiting were determined to have H. pylori gastritis by endoscopy, h istology, and a Giemsa stain positive for H. pylori, The patients were rand omized to receive amoxicillin, metronidazole, and bismuth subcitrate for 7 days (group A; 45 children) or 14 days (group B; 45 children) and were obse rved clinically for 19 +/- 11.5 months. Resolution of all abdominal and gas trointestinal symptoms was considered a good response. Results: A good response was obtained in 36 (80%) children from group A, an d in 37 (82%) from group B. A recurrence of symptoms occurred in four (11%) of the responders from group A, and in six (15.2%) from group B. Conclusions: A 7-day course of bismuth-based triple therapy for H. pylori g astritis in children appears to be clinically as effective as a 14-day regi men. The feasibility of a shorter therapeutic regimen may enhance patient c ompliance and provide a better chance of clinical benefit.