A Comparison Study of Sequential Therapy and Standard Triple Therapy in Children with Helicobacter Pylori Infection

Abstract

Introduction: The prevalence of Helicobacter pylori infection is 50 % of population in developing countries, and 35% in developed countries. Because of its major role in the pathogenesis of several gastrointestinal diseases like: chronic gastritis, ulcer disease, and gastric adenocarcinoma, many therapeutic regimens have been proposed to obtain a good eradication rate. However, it was observed that the eradication rate was low year after year, and the most likely reason for this is development of strains of organic matter resistant to antibiotic. There are several studies around the world, suggested that the sequential therapy was better than the triple therapy in achieving eradication.

Objectives: The present study aims to evaluate the effectiveness of sequential regimen in overcoming CLA and MET resistances and consequently in improving eradication rates in children with H.pylori infection and compare it with the results of the convential triple regimen.

Methods: The study took a place in Children’s University Hospital in Damascus over a period of one year. It included 60 children (median age 8.8 years), with H.pylori gastritis. All the included patients received a 10-day sequential therapy. The eradication was verified by clinical improvement of symptoms and the stool antigen testing after 4 weeks from the end of the treatment. Then it was Compared with historic cohort of pediatric patients with H. pylori infection, who were treated with standard triple therapy.

Results: The eradication rate of sequential therapy was 90 %, which is higher compared to the eradication rate of the triple therapy, which was 74%.

Conclusion: The present study suggests the use of sequential therapy as the first choice for H. pylori infection in children, due to its satisfactory results.