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Efficacy and safety of bismuth‐based quadruple therapy for Helicobacter pylori eradication in children
Author(s) -
Kotilea Kallirroi,
Cadranel Samy,
Salame Assaad,
Nguyen Julie,
Mahler Tania,
Miendje Deyi Véronique Yvette,
Verset Laurine,
Bontems Patrick
Publication year - 2021
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12825
Subject(s) - medicine , helicobacter pylori , gastroenterology , adverse effect , nausea , clarithromycin , rash , vomiting , metronidazole , abdominal pain , amoxicillin , population , esomeprazole , urea breath test , diarrhea , antibiotics , helicobacter pylori infection , environmental health , microbiology and biotechnology , biology
Abstract Objectives To evaluate the efficacy and safety of a 10‐day quadruple therapy containing colloidal bismuth sub‐citrate (CBS), esomeprazole (ESO), amoxicillin (AMO), and metronidazole (MET) for Helicobacter pylori ( H . pylori ) eradication in children. Methods Monocentric, open‐label, prospective, single‐arm clinical trial in children aged 6–17 years with H . pylori infection. The study was carried out on consecutive patients with upper gastrointestinal symptoms and H . pylori infection confirmed by histology and culture of gastric biopsies. The outcome was evaluated using a 13 C‐urea breath test 8–10 weeks post‐therapy. Adverse events and compliance were evaluated by daily journal and pill counting. Results A total of 36 children fulfilling the inclusion criteria were enrolled. Eight (22.2%) of them had a prior H . pylori eradication treatment. Thirteen (36.1%) patients were infected by a strain resistant to MET and 8 (22.2%) by a strain resistant to both MET and Clarithromycin (CLA). In the intention‐to‐treat population (ITT), eradication was achieved in 35/36 patients ( 95%CI : 85%−99% ). Twenty‐three children reported at least one adverse event (63.8%), mostly mild (nausea, vomiting, abdominal pain, diarrhea, dark stool, metallic taste, headache, and rash). The compliance rate was high, with 30 (83.3%) patients taking >90% of the treatment. Conclusion 10‐day quadruple therapy containing CBS, ESO, AMO, and MET for H . pylori eradication in children is a safe and very effective solution, especially for previously treated patients and those infected with double resistant strains.