Therapeutic Outcome and Recurrence Rate of Helicobacter pylori Infection in Children / 대한소아소화기영양학회지

ABSTRACT

PURPOSE: This study aimed at evaluating the therapeutic outcome, cost effectiveness and recurrence rate in children with H. pylori infection after the treatment using various medications. METHODS: Seventy five children (mean age 11.4+/-2.5 years) were given an endoscopy with biopsy and H. pylori status assessed by CLO test and histologic examination (Warthin Starry stain). Children were given one of following medications such as DA (Denol(R) and amoxycillin), OA (omeprazole and amoxycillin), DC (Denol(R) and clarithromycin) as primary treatment. And one of following medications such as DAM (Denol(R), amoxycillin and metronidazole), DC, OA, OC (omeprazole and clarithromycin) were used in children who failed the eradication of H. pylori. RESULTS: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9), duodenal ulcer (6), superficial gastritis (6), and normal (8). H. pylori eradication rate was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily) and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4 of 75 children between 3 months and 3 years after completion of the treatment of DA, yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2 cases, H. pylori infection persisted. CONCLUSION: These results suggest that dual therapy with Denol(R) and amoxycillin is the effective medications in treating H. pylori infection in children. Concerning the cost effectiveness, it can Austrabe recommended as first line treatment of choice as well.