Journal article
Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry
Infection, Vol.51(4), pp.921-934
08/01/2023
DOI: 10.1007/s15010-022-01948-y
PMID: 36329342
Abstract
The EuroPedHp-registry aims to monitor guideline-conform management, antibiotic resistance, and eradication success of 2-week triple therapy tailored to antibiotic susceptibility (TTT) in Helicobacter pylori-infected children.
From 2017 to 2020, 30 centres from 17 European countries reported anonymized demographic, clinical, antibiotic susceptibility, treatment, and follow-up data. Multivariable logistic regression identified factors associated with treatment failure.
Of 1605 patients, 873 had follow-up data (53.2% female, median age 13.0 years, 7.5% with ulcer), thereof 741 (85%) treatment naïve (group A) and 132 (15%) after failed therapy (group B). Resistance to metronidazole was present in 21% (A: 17.7%, B: 40.2%), clarithromycin in 28.8% (A: 25%, B: 51.4%), and both in 7.1% (A: 3.8%, B: 26.5%). The majority received 2-week tailored triple therapy combining proton pump inhibitor (PPI), amoxicillin with clarithromycin (PAC) or metronidazole (PAM). Dosing was lower than recommended for PPI (A: 49%, B: 41%) and amoxicillin (A: 6%, B: 56%). In treatment naïve patients, eradication reached 90% (n = 503, 95% CI 87-93%) and 93% in compliant children (n = 447, 95% CI 90-95%). Tailored triple therapy cured 59% patients after failed therapy (n = 69, 95% CI 48-71%). Treatment failure was associated with PAM in single clarithromycin resistance (OR = 2.47, 95% CI 1.10-5.53), with PAC in single metronidazole resistance (OR = 3.44, 95% CI 1.47-8.08), and with low compliance (OR = 5.89, 95% CI 2.49-13.95).
Guideline-conform 2-weeks therapy with PPI, amoxicillin, clarithromycin or metronidazole tailored to antibiotic susceptibility achieves primary eradication of ≥ 90%. Higher failure rates in single-resistant strains despite tailored treatment indicate missed resistance by sampling error.
Details
- Title: Subtitle
- Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry
- Creators
- Thu Giang Le Thi - LMU KlinikumKatharina Werkstetter - LMU KlinikumKallirroi Kotilea - Queen Fabiola Children's University HospitalPatrick Bontems - Université Libre de BruxellesJosé Cabral - Pediatric Gastroenterology Unit, Dona Estefânia Hospital, University Hospital Centre of Central Lisbon, Lisbon, PortugalMaria Luz Cilleruelo Pascual - Pediatrics Department, Gastroenterology Unit, University Hospital Puerta de Hierro Majadahonda, Madrid, SpainMichal Kori - Hebrew University of JerusalemJosefa Barrio - Hospital Universitario de FuenlabradaMatjaž Homan - University of LjubljanaNicolas Kalach - Groupe Hospitalier de l'Institut Catholique de LilleRosa Lima - Centro Hospitalar do PortoMarta Tavares - Centro Hospitalar do PortoPedro Urruzuno - Research Institute Hospital 12 de OctubreZrinjka Misak - Children's Hospital ZagrebVaidotas Urbonas - Vilnius UniversitySibylle Koletzko - LMU KlinikumHelicobacter pylori Special Interest Group of ESPGHANMeltem Korkut Ugras (Contributor) - Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Resource Type
- Journal article
- Publication Details
- Infection, Vol.51(4), pp.921-934
- DOI
- 10.1007/s15010-022-01948-y
- PMID
- 36329342
- ISSN
- 0300-8126
- eISSN
- 1439-0973
- Language
- English
- Date published
- 08/01/2023
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9985214101102771
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