The effectiveness of various schemes of eradication therapy in children with helicobacter-asociated diseases of upper gastrointestinal tract
DOI:
https://doi.org/10.15587/2313-8416.2016.61176Keywords:
children, Helicobacter pylori, pathology of the superior portions of gastro-intestinal tract, treatmentAbstract
Despite the progress achieved in the eradication of H. pylori, the emergence of resistant strains of microorganism requires the search for new medications and treatment regimens.
Methods. The study involved 160 children aged 8 - 18 years with disorders of the upper gastrointestinal tract associated with Helicobacter. Mucosal biopsies were used for detection of H. Pylori, CagA antigen and antibodies to CagA antigen were tested in stool before the treatment and 4-6 weeks after the treatment (eradication control). Children were divided into eight groups according to the schemes of Helicobacter therapy. The processing of the results was performed using data analysis package Microsoft Office Excel (2003). The difference of indices between the groups was determined using Student's t criteria and considered to be significant at p <0.05.
Results. It was figured out that in children who took proton pump inhibitors, clarithromycin and nifuratel during 7 and 10 days in anti-Helicobacter therapy was the fastest regression of the main clinical manifestations of the disease was observed (p <0.05). The highest effect of eradication was achieved in patients taking proton pump inhibitor, clarithromycin and nifuratel within 10 days (90%, decrease of relative risk of recurrence is 0.44 (CI: 0.17 - 5.45), and the number of patients who should receive treatment to achieve one positive result - 3.3 (CI: 1.13 - 12.28).
Conclusions.
1. Different efficiency of Helicobacter therapy in children with Helicobacter-associated pathologies of the upper gastrointestinal tract was determined.
2. Eradication of H. pylori was observed in 80% of children in third, sixth and seventh groups. The most effective scheme of anti-Helicobacter therapy in children was the use of proton pump inhibitor, clarithromycin and nifuratel within 10 days (90 % eradication)
References
Zimmerman, J. S. (2015). Gastrojenterologija. Rukovodstvo [Gastroenterology. Manual]. Moscow: HЕOTAR-Medik, 816.
Bogdanov, D. J., Vashchenko, I. I., Surkacheva, O. A., Astapenkov, Y. I. (2011). Bolezny orhanov pyshchevarenyya pry khelykobakteryoze [Diseases of the digestive system with Helicobacter pylori infection]. Moscow: OOO "Medical News Agency", 224.
Yvashkyn, V. T., Bohdanov, D. Yu., Lapyna, T. L. (2013). Gastrojenterologija. Klinicheskoe rukovodstvo [Gastroenterology. Manual]. Moscow: HEOTAR, 208.
Malfertheiner, P., Mégraud, F., OʼMorain, C., Bell, D., Porro, B. G., Deltenre, M. et. al (1997). Current European concepts in the management of Helicobacter pylori infection - the Maastricht Consensus Report. European Journal of Gastroenterology & Hepatology, 9 (1), 1–2. doi: 10.1097/00042737-199701000-00002
Malfertheiner, P., Megraud, F., O’Morain, C., Hungin, A. P. S., Jones, R., Axon, A. et. al (2002). Current concepts in the management of Helicobacter pylori infection-The Maastricht 2-2000 Consensus Report. Alimentary Pharmacology and Therapeutics, 16 (2), 167–180. doi: 10.1046/j.1365-2036.2002.01169.x
Malfertheiner, P., Megraud, F., O’Morain, C., Bazzoli, F., El-Omar, E., Graham, D. et. al (2007). Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut, 56 (6), 772–781. doi: 10.1136/gut.2006.101634
Malfertheiner, P., Megraud, F., O’Morain, C. A., Atherton, J., Axon, A. T. R., Bazzoli, F. et. al (2012). Management of Helicobacter pylori infection – the Maastricht IV/ Florence Consensus Report. Gut, 61 (5), 646–664. doi: 10.1136/gutjnl-2012-302084
Standartyi diagnostiki i lecheniya kislotozavisimyih i assotsiirovannyih s Helicobacter pylori zabolevaniy (chetvertoe Moskovskoe soglashenie) [Diagnostic standards and treatment of acid and Helicobacter pylori-associated diseases (fourth Moscow Agreement)] (2010). Guidelines Moscow City Department of Health, № 37. Moscow: CNIIG, 12.
Leanza, A. G., Matteo, M. J., Crespo, O., Antelo, P., Olmos, J., Catalano, M. (2004). Genetic characterisation of Helicobacter pylori isolates from an Argentinean adult population based on cag pathogenicity island right-end motifs, lspA-glmM polymorphism and iceA and vacA genotypes. Clinical Microbiology and Infection, 10 (9), 811–819. doi: 10.1111/j.1198-743x.2004.00940.x
Kato, S., Fujimura, S. (2010). Primary antimicrobial resistance of Helicobacter pylori in children during the past 9 years. Pediatrics International, 52 (2), 187–190. doi: 10.1111/j.1442-200x.2009.02915.x
Boyanova, L. (2009). Prevalence of multidrug-resistant Helicobacter pylori in Bulgaria. Journal of Medical Microbiology, 58 (7), 930–935. doi: 10.1099/jmm.0.009993-0
Yuan, Y., Ford, A. C., Khan, K. J., Gisbert, J. P., Forman, D., Leontiadis, G. I. et. al (2013). Optimum duration of regimens for Helicobacter pylori eradication. John Wiley & Sons. doi: 10.1002/14651858.cd008337.pub2
Machado, R. S., da Silva, M. R., Viriato, A. (2008). Furazolidone, tetracycline and omeprazole: a low-cost alternative for Helicobacter pylori eradication in children. Jornal de Pediatria, 84 (2), 160–165. doi: 10.2223/jped.1772
Filipec Kanizaj, T., Katicic, M., Skurla, B., Ticak, M., Plecko, V., Kalenic, S. (2009). Helicobacter pylori Eradication Therapy Success Regarding Different Treatment Period Based on Clarithromycin or Metronidazole Triple-Therapy Regimens. Helicobacter, 14 (1), 29–35. doi: 10.1111/j.1523-5378.2009.00656.x
Alvarez, A., Moncayo, J. I., Santacruz, J. J., Santacoloma, M., Corredor, L. F., Reinosa, E. (2009). Antimicrobial Susceptibility and Mutations Involved in Clarithromycin Resistance in Helicobacter pylori Isolates from Patients in the Western Central Region of Colombia. Antimicrobial Agents and Chemotherapy, 53 (9), 4022–4024. doi: 10.1128/aac.00145-09
Bago, J., Majstorović, K., Belošić-Halle, Ž., Kućišec, N., Bakula, V., Tomić, M. et. al (2010). Antimicrobial resistance of H. pylori to the outcome of 10-days vs. 7-days Moxifloxacin based therapy for the eradication: a randomized controlled trial. Annals of Clinical Microbiology and Antimicrobials, 9 (1), 13. doi: 10.1186/1476-0711-9-13
Basu, P. P., Rayapudi, K., Pacana, T., Shah, N. J., Krishnaswamy, N., Flynn, M. (2011). A Randomized Study Comparing Levofloxacin, Omeprazole, Nitazoxanide, and Doxycycline versus Triple Therapy for the Eradication of Helicobacter pylori. The American Journal of Gastroenterology, 106 (11), 1970–1975. doi: 10.1038/ajg.2011.306
Burkova, V. V. (2012). Ispolzovanie nifuratelya v eradikatsionnoy sheme pri lechenii helikobakterioza v detey [Using nifuratel eradication scheme in the treatment of children in helikobakter]. Medicine, 2, 45–47.
Drumm, B., Koletzko, S., Oderda, G. (2000). Helicobacter pylori Infection in Children: A Consensus Statement. Journal of Pediatric Gastroenterology and Nutrition, 30 (2), 207–213. doi: 10.1097/00005176-200002000-00020
Protokoly diagnostyky ta likuvannja zahvorjuvan' organiv travlennja u ditej (2010). Ministerstvo osvity i nauky Ukrai'ny; Nakaz MOZ Ukrai'ny vid 26.05.2010 roku № 438. Kyiv. Available at: http://www.moz.gov.ua/ua/portal/dn_20100526_438.html
Dore, M. P., Farina, V., Cuccu, M., Mameli, L., Massarelli, G., Graham, D. Y. (2011). Twice-a-Day Bismuth-Containing Quadruple Therapy for Helicobacter Pylori Eradication: A Randomized Trial of 10 and 14 Days. Helicobacter, 16 (4), 295–300. doi: 10.1111/j.1523-5378.2011.00857.x
Fujioka, T., Aoyama, N., Sakai, K., Miwa, Y., Kudo, M., Kawashima, J. et. al (2011). A large-scale nationwide multicenter prospective observational study of triple therapy using rabeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in Japan. Journal of Gastroenterology, 47 (3), 276–283. doi: 10.1007/s00535-011-0487-6
Nakajima, S., Inoue, H., Inoue, T., Maruoka, Y. (2012). Multiple-antibiotic-resistant Helicobacter pylori infection eradicated with a tailor-made quadruple therapy. Journal of Gastroenterology and Hepatology, 27, 108–111. doi: 10.1111/j.1440-1746.2012.07069.x
Kornienko, E. A., Parolova, N. I. (2006). Antibiotikorezistentnost Helicobacter pylori u detey i vyibor terapii [Antibiotic resistance of Helicobacter pylori in children and the choice of therapy]. Questions modern pediatry, 5, 5.
Marais, A., Bilardi, C., Cantet, F., Mendz, G. L., Mégraud, F. (2003). Characterization of the genes rdxA and frxA involved in metronidazole resistance in Helicobacter pylori. Research in Microbiology, 154 (2), 137–144. doi: 10.1016/s0923-2508(03)00030-5
Mégraud, F. (2002). Helicobacter pylori and macrolides. Macrolide Antibiotics, 243–260. doi: 10.1007/978-3-0348-8105-0_15
Mendz, G. (2002). Is the molecular basis of metronidazole resistance in microaerophilic organisms understood? Trends in Microbiology, 10 (8), 370–375. doi: 10.1016/s0966-842x(02)02405-8
Shiota, S., Murakawi, K., Suzuki, R., Fujioka, T., Yamaoka, Y. (2013). Helicobacter pylori infection in Japan . Expert Review of Gastroenterology & Hepatology, 7 (1), 35–40. doi: 10.1586/egh.12.67
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