Pediatr Gastroenterol Hepatol Nutr.  2012 Dec;15(4):237-242.

Efficacy of Proton Pump Inhibitor-based Triple Therapy and Bismuth-based Quadruple Therapy for Helicobacter pylori Eradication in Korean Children

• Hong J
• Yang HR

Abstract

PURPOSE
The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children.
METHODS
We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment.
RESULTS
Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group.
CONCLUSION
This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.

Keyword

Helicobacter pylori; Therapeutics; Disease eradication; Child

MeSH Terms

Amoxicillin
Bismuth
Child
Clarithromycin
Disease Eradication
Helicobacter
Helicobacter pylori
Humans
Metronidazole
Omeprazole
Proton Pumps
Protons
Retrospective Studies
Salts
Amoxicillin
Bismuth
Clarithromycin
Metronidazole
Omeprazole
Proton Pumps
Protons
Salts

Figure

• 

  Fig. 1 Comparison of the Helicobacter pylori eradication rates of 2 different regimens. The eradication rate in the OAMB group was significantly higher than that in the OAC group (p=0.041). OAC: omeprazole, amoxicillin, clarithromycin, OAMB: omeprazole, amoxicillin, metronidazole, bismuth salts.

• 

  Fig. 2 Serial eradication rates of the Helicobacter pylori infection during 3 periods of time. The eradication rates in the OAMB group during each period were all superior to those in the OAC group, especially during 2010-2012 (p=0.01). OAC: omeprazole, amoxicillin, clarithromycin, OAMB: omeprazole, amoxicillin, metronidazole, bismuth salts.

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