OMEPRAZOLE-BASED DUAL AND TRIPLE REGIMENS FOR HELICOBACTER-PYLORI ERADICATION IN CHILDREN

Objective. To evaluate the efficacy and safety of omeprazole-based dua l and triple regimens for the treatment of children with Helicobacter pylori infection. Methods. Twenty-two patients (3 with gastric ulcer, 12 with duodenal ulcer, and 7 with nodular gastritis alone) were studi ed. Twelve ulcer patients also had nodular gastritis. The dual regimen included a 2-week course of omeprazole (0.6 mg/kg twice a day) and am oxicillin (30 mg/kg twice a day) (n = 10), and the triple regimen incl uded the dual regimen plus clarithromycin (15 mg/kg twice a day) (n = 12). In patients with active ulcers, omeprazole once daily was adminis tered for another 4 weeks. Endoscopic biopsies were taken before thera py and 4 weeks after completion of a 2-week course of therapy, and pat ients were followed for 6 months. The gastritis score (grade 0 to 3) a nd serum anti-H pylori IgG antibody titers were also determined. Resul ts. The regimens were tolerated by all patients. Eradication rates for the dual and triple regimens were 70% and 92%, respectively. Active d eers completely healed within 6 weeks. Patients with nodular gastritis alone showed different clinical responses to therapy. Pretreatment hi stology showed chronic gastritis in all patients. Successful H pylori eradication significantly reduced the mean gastritis score from 2.9 to 1.3, but unsuccessful eradication did not reduce it. The disappearanc e of antral nodularity often coincided with the success of eradication . Successful eradication significantly decreased pretreatment serum an ti-H pylori IgG antibody titers by 29% at 1 month, by 52% at 3 months, and by 67% at 6 months. Side effects were mild and were reported in 2 3% of patients. Conclusion. An omeprazole-based regimen is safe and ma y be a better option for eradication of H pylori in children. Antral n odularity is a macroscopic marker of H pylori infection.