The success of H. pylori eradication therapy using a quadruple sequential treatment in children with gastrointestinal symptoms seen in a pediatric practice in the US-Mexico border region
Clinical trials of Helicobacter pylori treatment in children are scarce and there is no solid recommendation as the most effective and proper eradication therapy. It is currently accepted that children should be treated with a triple continuous therapy with Amoxicillin, Clarithromycin and a Proton Pump Inhibitor for 7-14 days. However, bacterial resistance to Clarithromycin has been postulated as one of the reasons of treatment failure. Objective. To observe the effectiveness of a 10 day modified sequential eradication treatment with a Proton Pump Inhibitor plus Amoxicillin for 10 days, concomitantly giving Clarithromycin the first 5 days, followed by 5 days of Metronidazole. Methods. A cohort of twelve pediatric patients diagnosed with H. pylori infection by a urea breath test levels greater than 10 micrograms per liter per minute, in a rural pediatric private practice that participated in a separate study by Wang, et al. (2014) were given a modified sequential eradication therapy for 10 days. Urea breath test levels before and 28 days after treatment were recorded. A patient was considered cured if urea breath test levels fell below a threshold level of 10 micrograms per liter per minute. Data obtained was statistically analyzed with descriptive statistics and a t-test of the paired two samples of the mean. Results. Of the patients, 50% were males and 50% were females, all had history of chronic abdominal pain and patients also reported other gastrointestinal symptoms such as constipation, acid reflux and loss of appetite. Half of the patients responded to treatment and were cured. The other 50% of patients, five (42%) did not follow the treatment as prescribed with the recommended sequence of the medications. Only one patient did follow the prescribed treatment and failed to drop the urea breath test levels below 10 micrograms per liter per minute (16 mcg/lt/min). Treatment effectiveness was statistically significant with a t test = 2.201, p = 0.007 at 95% CI [25.09 - 126.95]. Conclusions. This small pilot study demonstrates that a modified quadruple eradication therapy is an effective treatment option for children with H. pylori infection. It has limitations due to being a small study cohort and the sample consist of Hispanics in lower socioeconomic status only. Nevertheless, it can serve as a lead point to a bigger and better designed study with aims at providing a better and more concise H. pylori infection treatment recommendation in the pediatric population
Pharmacology|Latin American Studies|Health care management
Ocaranza, Hector Ignacio, "The success of H. pylori eradication therapy using a quadruple sequential treatment in children with gastrointestinal symptoms seen in a pediatric practice in the US-Mexico border region" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1586829.