How are pediatric Helicobacter pylori (Hp) infections treated?

Updated: Nov 16, 2018
  • Author: Mutaz I Sultan, MBChB, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Antibiotic resistance is the major cause of failure in the treatment of H pylori infection. Most of the studies worldwide confirmed an increase in macrolide resistance, while metronidazole resistance either decreased or remained stable. In a prospective multicenter European study, primarily comprised of adults, Megraud et al found a 31.8% resistance rate to clarithromycin and 25.7% to metronidazole in the 311 H pylori isolates from children from the 8 countries included in the study. [33]

If the strain is resistant to one of the antibiotics used, treatment success will be compromised. As a result therapies that are recommended should be based on antibiotic susceptibility testing. If this testing is not available, then clarithromycin-based triple therapy should not be used as part of first-line therapy due to high rates of clarithromycin resistance rates. [31]


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