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Nationwide survey of Helicobacter pylori treatment for children and adolescents in Japan
Author(s) -
Okuda Masumi,
Kikuchi Shogo,
Mabe Katsuhiro,
Osaki Takako,
Kamiya Shigeru,
Fukuda Yoshihiro,
Kato Mototsugu
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13038
Subject(s) - medicine , helicobacter pylori , metronidazole , amoxicillin , adverse effect , clarithromycin , gastritis , gastroenterology , antibiotics , microbiology and biotechnology , biology
Background To prevent gastric cancer, a test‐and‐treat strategy for Helicobacter pylori has been proposed. This retrospective study assessed the clinical features, efficacy and safety of treatment for H. pylori infection in children and adolescents. Methods Questionnaires concerning the clinical features and treatment of H. pylori in children and adolescents were sent to doctors in 2013. It included questions on patient background, H. pylori‐ associated disease, first‐ and second‐line treatment, success or failure of eradication, resistance to antibiotics, and occurrence of adverse events. In 2014, serious adverse events associated with treatment were analyzed. Results Invitation letters and questionnaires were sent to 1097 doctors, of whom 409 (37.3%) participated. Finally, 332 patients (mean age, 11.6 ± 3.4 years; male, n = 200) treated from 1997 to 2013 were analyzed. H. pylori‐ associated gastritis, iron deficiency anemia, and duodenal ulcer occurred most frequently. Success rates for first‐ and second‐line treatments were 73.1% and 79.6%, respectively. Seventy‐six H. pylori strains were analyzed for resistance to amoxicillin ( AMPC ) and clarithromycin ( CAM ), and 64 were analyzed for resistance to metronidazole ( MNZ ). CAM resistance was most frequent, occurring in 43.4% of patients; that of MNZ was 21.9%. Adverse events were observed in 13.8% of cases. In total, 587 cases of H. pylori infection were analyzed and no serious adverse events were observed. Conclusions Treatment for H. pylori in children and adolescents is safe, but further studies on treatment regimens should be conducted to improve eradication rates and monitor increasing CAM resistance.