Omeprazole combined with amoxicillin and clarithromycin in the eradicationof Helicobacter pylori in children with gastritis: A prospective randomized double-blind trial

Objectives: The aim of this multicenter prospective, randomized, double-bli nd study was to assess the efficacy of the combination of omeprazole, amoxi cillin, and clarithromycin (OAC) For the treatment of Helicobacter pylori g astritis in children. Study design: Seventy-three children with dyspeptic symptoms were included in the trial (mean age 10.8 years; range, 3.3 to 15.4). Patients were rando mized to receive OAC or amoxicillin and clarithromycin (AC) for 7 days. H p ylori status was assessed before and 4 weeks after eradication treatment, b y use of the carbon 13-labeled urea breath test. Results: In intent-to-treat analysis (n = 63), eradication rates were 74.2% (95% CI, 58.7 to 89.6) in the OAC group and 9.4% (95% CI, 0 to 19.5) in th e AC group. In per-protocol analysis (n = 53), the eradication rate increas ed to 80% (95% CI, 64.3 to 95.7), remaining significantly higher than in AC group (10.7%; 95% CI, 0 to 22.2). Resistance of strains to clarithromycin was rare (3/39 = 7.7%) and was not associated with failure of treatment. Ad verse events were reported in 24.6% of patients and remained mild. Conclusion: This study shows that 1-week OAC triple therapy results in succ essful eradication of H pylori in 75% of children with gastritis.