What is the role of triple or sequential therapy in 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

Previous guideline recommendations of triple or sequential therapy for treatment-naïve H pylori–infected children and adolescents can no longer be supported. Instead, to achieve an initial eradication success rate of 90% and higher, therapy should be based on knowledge of antibiotic resistance profiles and therapy tailored accordingly using sufficiently high doses and treatment durations of 10 to 14 days. Clarithromycin-containing regimens should be restricted to those infected with clarithromycin-susceptible strains. When antibiotic susceptibility profiles are not known, high-dose triple therapy with PPI, amoxicillin, and metronidazole for 14 days is recommended as first-line therapy. Bismuth-based quadruple therapy can also be considered for first-line therapy in countries where it is licensed for use in children. [31]


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