Dehghani Seyed Mohsen, Erjaee Asma, Imanieh Mohammad Hadi, Haghighat Mahmood
Gastroenterohepatology Research Center, Pediatric Gastroenterology Department, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, 71937-11351, Iran.
Dig Dis Sci. 2009 Aug;54(8):1720-4. doi: 10.1007/s10620-008-0547-9. Epub 2008 Nov 14.
Helicobacter pylori (H. pylori) cure rates vary in different geographical regions because of differences in hosts as well as in H. pylori strains. In this study we evaluated the efficacy of different treatment regimens for eradication of H. pylori infection in children, in order to select a treatment regimen that is most effective with the least adverse effects and cost.
Through a randomized clinical trial study we enrolled 120 pediatric patients (age <or= 18 years) with H. pylori infection confirmed through histopathological examination of their upper endoscopic findings and positive rapid urease test. Patients were randomized into three groups: group A received omeprazole, amoxicillin, metronidazole, and bismuth subcitrate; group B received omeprazole, amoxicillin, and clarithromycin; and group C the most recent regime of omeprazole, amoxicillin-clavulanic acid, and metronidazole. Subjects were followed 6 weeks after completing the antimicrobial therapy and H. pylori eradication was assessed with urea breath test.
A total of 117 patients with a mean age of 12 +/- 4 years completed the study. Eradication rate was 91.9% in group A, compared with 82.1% in group B, and 80.5% in group C (P = 0.33).
Considering these data we suggest quadruple therapy as the first line of therapy for eradication of H. pylori infection in children in our geographic area (Iran).
由于宿主以及幽门螺杆菌菌株的差异，幽门螺杆菌（H. pylori）的治愈率在不同地理区域有所不同。在本研究中，我们评估了不同治疗方案根除儿童幽门螺杆菌感染的疗效，以便选择一种疗效最佳、副作用最小且成本最低的治疗方案。
通过一项随机临床试验研究，我们纳入了120名儿科患者（年龄≤18岁），这些患者经上消化道内镜检查的组织病理学检查及快速尿素酶试验证实感染了幽门螺杆菌。患者被随机分为三组：A组接受奥美拉唑、阿莫西林、甲硝唑和枸橼酸铋钾治疗；B组接受奥美拉唑、阿莫西林和克拉霉素治疗；C组接受最新方案，即奥美拉唑、阿莫西林 - 克拉维酸和甲硝唑治疗。在完成抗菌治疗6周后对受试者进行随访，并通过尿素呼气试验评估幽门螺杆菌的根除情况。
共有117名平均年龄为12±4岁的患者完成了研究。A组的根除率为91.9%，B组为82.1%，C组为80.5%（P = 0.33）。
考虑到这些数据，我们建议在我们所在地理区域（伊朗），四联疗法作为根除儿童幽门螺杆菌感染的一线治疗方案。
