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Research ArticleOpen Access

Can Sequential Therapy Overcome Antimicrobial Resistance in Children with Helicobacter pylori Infection ?

Volume 4 - Issue 5

Federica Gaiani1*, Marco Manfredi2, Silvia Iuliano2, Gian Luigi de’Angelis1,2, Carmen Madia2,Barbara Bizzarri1, Fabiola Fornaroli1, Maria Clotilde Carra3 and Nicola de’Angelis4

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    • 1Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Italy
    • 2Pietro Barilla” Children’s Hospital, Department of Pediatrics, University Hospital of Parma, Italy
    • 3Rothschild Hospital, Université Paris 7, France
    • 4Department of Digestive, Henri Mondor University Hospital, France

    *Corresponding author: Federica Gaiani, Gastroenterology and Endoscopy Unit, University Hospital of Parma, 43126 Parma, Italy

Received: May 19, 2018;   Published: May 25, 2018

DOI: 10.26717/BJSTR.2018.04.001111

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Abstract

Introduction: Eradication rates of many therapeutic regimens for Helicobacter pylori (H. pylori) infection are not yet satisfactorily, mainly due to bacterial resistance to antibiotics, and to a limited availability of antibiotics in children.

Materials and Methods: Fifty-three children with H. pylori infection were prospectively enrolled, characterized by clinic, endoscopic findings and antibiotic resistance and treated with sequential therapy (ST cohort); this cohort was compared with an historic cohort of 106 children treated with standard triple therapy (TT cohort). The eradication rate of the two treatments was obtained, based on antibiotic resistance towards amoxicillin (AMO), metronidazole (MET), and clarithromycin (CLA).

Results: In the ST cohort: 27 patients (51%) resulted susceptible towards antibiotics; the eradication rate was of 88.7% (47/53 patients) overall, and of 84.6% (22/26 patients) among patients with resistance. In the TT cohort: 53 (50%) resulted susceptible towards antibiotics; the eradication rate was of 87.7% (93/106 patients) overall, and of 79.2% (42/53 patients) among patients with resistance. The two cohorts had a similar overall eradication rate (p value 0.23), while the eradication rate in patients with resistance was significantly higher for the ST cohort (p value 0.04).

Conclusion: Sequential regimen could be a valid option to eradicate H. pylori infection, especially in case of antimicrobial resistance.

Abbreviations: AMO:amoxicillin, CLA:clarithromycin,MET: metronidazole, PPI: Proton Pump Inhibitor,SPSS: Statistical Package for Social Science triple, TT: therapy, ST: sequential therapy, PPI: Proton Pump Inhibitor

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