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Antibiotics taken for other illnesses and spontaneous clearance of Helicobacter pylori infection in children
Author(s) -
Broussard Cheryl S,
Goodman Karen J,
Phillips Carl V,
Smith Mary Ann,
Fischbach Lori A,
Day R Sue,
Aragaki Corinne C
Publication year - 2009
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1773
Subject(s) - medicine , helicobacter pylori , antibiotics , cohort , helicobacter pylori infection , confidence interval , breath test , pediatrics , gastroenterology , microbiology and biotechnology , biology
Purpose Factors that determine persistence of untreated Helicobacter pylori ( H. pylori) infection in childhood are not well understood. We estimated risk differences for the effect of incidental antibiotic exposure on the probability of a detected clearance at the next test after an initial detected H. pylori infection. Methods The Pasitos Cohort Study (1998–2005) investigated predictors of H. pylori infection in children from El Paso, Texas, and Juarez, Mexico. Children were screened for infection at 6‐month target intervals from 6 to 84 months of age, using the 13 C‐urea breath test corrected for body‐size‐dependent variation in CO 2 production. Exposure was defined as courses of any systemic antibiotic (systemic) or those with anti‐ H. pylori action (HP‐effective) reported for the interval between initial detected infection and next test. Binomial regression models included country of residence, mother's education, adequacy of prenatal care, age at infection, and interval between tests. Results Of 205 children with a test result and antibiotic data following a detected infection, the number of children who took ≥1 course in the interval between tests was 74 for systemic and 33 for HP‐effective. The proportion testing negative at the next test was 66% for 0 courses, 72% for ≥1 systemic course, and 79% for ≥1 HP‐effective course. Adjusted risk differences (95%CI) for apparent clearance, comparing ≥1 to 0 courses were 10% (1–20%) for systemic and 11% (0–21%) for HP‐effective. Conclusions Incidental antibiotic exposure appears to influence the duration of childhood H. pylori infection but seems to explain only a small portion of spontaneous clearance. Copyright © 2009 John Wiley & Sons, Ltd.