Departments of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.
Department of Internal Medicine, Saiseikai Karatsu Hospital, Karatsu, Japan.
Helicobacter. 2021 Apr;26(2):e12776. doi: 10.1111/hel.12776. Epub 2020 Dec 23.
The screening and treatment of Helicobacter pylori infection for all junior high students in Saga Prefecture, Japan, were started in 2016. The present study aims to evaluate the influence of adverse reactions on the success of the eradication therapy.
From 2017 to 2019, 25,006 third-grade junior high school students were tested for urinary anti-H. pylori antibodies. Positive cases were confirmed by H. pylori stool antigen tests. Of the 531 students who were found to be H. pylori-positive, 390 (358 in first-line and 32 in second-line therapy) underwent eradication therapy, and 274 (242 in first-line and 32 in second-line) students actually completed a self-reported form to rate stool consistency (based on the Bristol Stool Scale), the maximum number of bowel movements, and abdominal symptoms during the 7 days of treatment.
Among the 274 students, the total of primary and secondary eradication success rates was 87% (95% confidential interval: 82.9-90.1) in intention-to-treat analysis. On days 4, 5, and 6, stool consistency was looser in the primary eradication failure group than in the success group (p < .05). Looser stool consistencies were observed in male students with abdominal pain compared to those who did not experience pain (p < .05). Abdominal pain and diarrhea were detected in 28.5% and 42.7% of the subjects, respectively. The overall incidence of other adverse events was low (n = 8/274, 2.9%), and only two students discontinued treatment because of adverse events.
Softening of the stool was related to the eradication failure in the junior high school students, especially in males with abdominal pain. Adverse effects did not induce discontinuation of the eradication treatment.
日本佐贺县自 2016 年起开始对所有初中生进行幽门螺杆菌感染筛查和治疗。本研究旨在评估不良反应对根除治疗成功的影响。
2017 年至 2019 年，对 25006 名初三学生进行尿抗 H. pylori 抗体检测。阳性者行 H. pylori 粪便抗原检测。在 531 名 H. pylori 阳性学生中，390 名（一线治疗 358 例，二线治疗 32 例）进行了根除治疗，274 名（一线治疗 242 例，二线治疗 32 例）实际完成了一份自评表，以评估治疗 7 天内粪便稠度（基于布里斯托粪便量表）、最大排便次数和腹部症状。
在 274 名学生中，意向治疗分析的总初级和次级根除成功率为 87%（95%可信区间：82.9-90.1）。在第 4、5 和 6 天，初级根除失败组的粪便稠度比成功组更松散（p<0.05）。有腹痛的男性学生的粪便稠度比没有腹痛的学生更松散（p<0.05）。腹痛和腹泻分别在 28.5%和 42.7%的受试者中出现。总体不良反应发生率较低（n=274，8/274，2.9%），仅 2 名学生因不良反应停止治疗。
粪便变软与初中生根除失败有关，尤其是有腹痛的男性。不良反应并未导致根除治疗中断。
