Table of Contents

HK J Paediatr (New Series)
Vol 8. No. 4, 2003

HK J Paediatr (New Series) 2003;8:341-345

Original Article

Helicobacter Pylori Eradication in Children with Ranitidine Bismuth

YH Tam, JDY Sihoe, KH Lee, CK Yeung


Helicobacter pylori infection is common in paediatric population. The overall prevalence varies from 10% in developed countries to 80% in developing countries at the age of 10. The association of this infection with gastritis, peptic ulcerations and gastric cancer has warranted guidelines on the treatment of this infection in children. Aim of study: To determine an effective eradication regimen for H. pylori in children with the shortest duration to promote compliance. Patients and methods: We conducted a prospective randomised study comparing ranitidine bismuth citrate (RBC) - based triple therapy given for 4 days vs 7 days in 200 children with mean age 12.5 years (92 boys, 108 girls). H. pylori infection was diagnosed by 13C-urea breath test (13C-UBT). Children with body weight > 40 kg received amoxicillin 1 g bid plus clarithromycin 500 mg bid plus RBC 400 mg bid. Dosages of antibiotics were reduced by half in those patients with body weight less than 40 kg while that of RBC remained the same. Outcome measures included success of eradication determined by repeat 13C-UBT in 6 weeks, drugs adverse effects and patients' compliance. Results: Ninety-three (46.5%) and 107 (53.5%) of children were randomised to receive 7-day and 4-day regimen respectively. All 200 children completed the prescribed treatment according to the protocol. 89.2% of children who had received treatment for 7 days showed successful eradication comparing with 78.5% in those who received treatment only for 4 days (p-value <0.05). There was no statistical difference in terms of side effects between the two regimens. Conclusions: RBC-based triple therapy is an effective and well tolerated treatment for eradication of H. pylori in children. Seven days of treatment is the shortest duration to ensure effective eradication with the currently available therapeutic agents.

幽門螺旋杆菌感染在兒童中很常見。10 歲兒童的發病率在發達國家為 10%,而在發展中國家高達 80%。此感染所伴發的胃炎、消化器官潰瘍及胃癌己成為兒童必須接受治療的依據。研究目的:為患有幽門螺旋杆菌感染的兒童制定一種有效的根治方法,縮短療程以提高病人的耐受性。病人及方法:我們在 200 名平均年齡為 12.5 歲的兒童中隨機對比研究了 4 天和 7 天的 RBC 三聯治療。(92 名男童,108 名女童)碳 13C 尿素呼吸試驗証實為幽門螺旋杆菌感染。體重超過 40 公斤的患兒接受 amoxicillin 1 g/每日 2 次,clarithromycin 500 mg/每日 2 次及 RBC 400 mg/每日 2 次的聯合治療。體重低於 40 公斤的患兒抗生素減至半量 RBC 保持相同劑量。成功根治的評估包括 6 周內重複進行碳 13C 尿素呼吸試驗,藥物副作用及病人的耐受性。結果:46.5% 及 53.5% 的患兒分別接受了為期 7 天及 4 天的治療。全部 200 名患兒完成了上述治療計劃。在接受 7 天治療的患兒中 89.2% 成功根除幽門螺旋杆菌感染。而在接受 4 天治療的患兒中僅 78.5% 成功根治。(p 值 <0.05)組治療的副作用在統計學方面無顯著性差異。結論:對於兒童患者,RBC 三聯治療是一種有效且耐受良好的幽門螺旋杆菌感染根治方法。應用現有的藥物治療,7 天是最短的確保有效根治的療程。

Keyword : Children; Eradication; Helicobacter pylori



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