Effectiveness of sequential v. standard triple therapy for treatment of
Helicobacter pylori infection in children in Nairobi, Kenya.
Author(s): Laving A(1), Kamenwa R, Sayed S, Kimang'a AN, Revathi G.
Affiliation(s): Author information:
(1)Department of Paediatrics and Child Health, University of Nairobi, Kenya;
Department of Paediatrics and Child Health, Aga Khan University Hospital,
Nairobi, Kenya. arlaving@yahoo.com.
Publication date & source: 2013, S Afr Med J. , 103(12):921-4
BACKGROUND: Once the diagnosis of Helicobacter pylori is confirmed, treatment
requires at least two antibiotics and an acid inhibitor for a minimum of seven
days. Unfortunately, treatment failures are being frequently reported. Treatment
regimens that include sequential administration of antibiotics with acid
inhibitors have been developed to try and increase the rate of eradication.
OBJECTIVE: To determine the effectiveness of a novel 10-day sequential therapy
compared with the standard 10-day triple therapy for treatment of H. pylori
infection in children.
METHODS: A double-blinded, randomised, controlled trial was conducted. Children
under the age of 16 years with recurrent abdominal pain associated with dyspepsia
and diagnosed with H. pylori by histology were randomly allocated either to a
10-day sequential treatment regimen or to a 10-day conventional triple therapy.
Analysis of the outcome of this study was based on clinical improvement and
confirmed H. pylori eradication based on stool H. pylori antigen detection and/or
repeat endoscopy.
RESULTS: Of the 71 patients included in the analysis, 45 (63.4%) were given the
10-day conventional treatment while 26 (36.6%) received the 10-day sequential
treatment. There was no difference in clinical improvement after treatment in the
two therapies. However, there was a significant difference in the eradication of
H. pylori between the conventional v. sequential regimens (48.8% v. 84.6%,
respectively; p=0.02, odds ratio 0.19).
CONCLUSION: The sequential treatment had a significantly higher H. pylori
eradication rate than the conventional treatment.
|
