Naslov
Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry

Autori
Le Thi, Thu Giang ; Werkstetter, Katharina ; Kotilea, Kallirroi ; Bontems, Patrick ; Cabral, José ; Cilleruelo Pascual, Maria Luz ; Kori, Michal ; Barrio, Josefa ; Homan, Matjaž ; Kalach, Nicolas ; Lima, Rosa ; Tavares, Marta ; Urruzuno, Pedro ; Misak, Zrinjka ; Urbonas, Vaidotas ; Koletzko, Sibylle ; Sykora, Josef ; Miele, Erasmo ; Krahl, Andreas ; Klemenak, Martina ; Papadopoulou, Alexandra ; Chiaro, Andrea ; Ugras, Meltem Korkut ; de Laffolie, Jan ; Matusiewics, Krzysztof ; Rea, Francesca ; Casswall, Thomas ; Roma, Eleftheria ; Banoub, Hany ; Cseh, Aron ; Rogalidou, Maria ; Lopes, Ana Isabel

Izvornik
Infection (0300-8126) 2022 Nov 3 (2022); 36329342, 14

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Antibiotic therapy ; Drug resistance ; Helicobacter pylori ; Helicobacter pylori—in children ; Paediatric gastroenterology

Sažetak
Purpose: The EuroPedHp-registry aims to monitor guideline- conform management, antibiotic resistance, and eradication success of 2-week triple therapy tailored to antibiotic susceptibility (TTT) in Helicobacter pylori-infected children. Methods: From 2017 to 2020, 30 centres from 17 European countries reported anonymized demographic, clinical, antibiotic susceptibility, treatment, and follow-up data. Multivariable logistic regression identified factors associated with treatment failure. Results: Of 1605 patients, 873 had follow-up data (53.2% female, median age 13.0 years, 7.5% with ulcer), thereof 741 (85%) treatment naïve (group A) and 132 (15%) after failed therapy (group B). Resistance to metronidazole was present in 21% (A: 17.7%, B: 40.2%), clarithromycin in 28.8% (A: 25%, B: 51.4%), and both in 7.1% (A: 3.8%, B: 26.5%). The majority received 2-week tailored triple therapy combining proton pump inhibitor (PPI), amoxicillin with clarithromycin (PAC) or metronidazole (PAM). Dosing was lower than recommended for PPI (A: 49%, B: 41%) and amoxicillin (A: 6%, B: 56%). In treatment naïve patients, eradication reached 90% (n = 503, 95% CI 87-93%) and 93% in compliant children (n = 447, 95% CI 90-95%). Tailored triple therapy cured 59% patients after failed therapy (n = 69, 95% CI 48-71%). Treatment failure was associated with PAM in single clarithromycin resistance (OR = 2.47, 95% CI 1.10-5.53), with PAC in single metronidazole resistance (OR = 3.44, 95% CI 1.47-8.08), and with low compliance (OR = 5.89, 95% CI 2.49-13.95). Conclusions: Guideline-conform 2-weeks therapy with PPI, amoxicillin, clarithromycin or metronidazole tailored to antibiotic susceptibility achieves primary eradication of ≥ 90%. Higher failure rates in single-resistant strains despite tailored treatment indicate missed resistance by sampling error.

Izvorni jezik
Engleski

POVEZANOST RADA