What is the efficacy of combination therapies for the treatment of pediatric Helicobacter pylori (Hp) infection?

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

Rescue therapy should be based on antibiotic resistance profiles when it is possible. Studies in adults suggest that increasing acid suppression and metronidazole dose may improve efficacy of eradication therapy. One study showed that in children infected with clarithromycin- and metronidazole-resistant strains, the eradication rate using high dose amoxicillin and PPI with metronidazole was 66% in intention to treat analysis. [31]

In a recent multicenter, open-label, single-arm, clinical trial of H pylori–positive adults who had failed more than one previous course of omeprazole-amoxicillin-clarithromycin therapy, a quadruple regimen of bismuth, metronidazole, and tetracycline plus omeprazole produced a high eradication rate (up to 95.8%). [34]


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