PMID- 15565402
OWN - NLM
STAT- MEDLINE
DCOM- 20050118
LR  - 20181201
IS  - 0944-1174 (Print)
IS  - 0944-1174 (Linking)
VI  - 39
IP  - 9
DP  - 2004 Sep
TI  - Results of triple eradication therapy in Japanese children: a retrospective 
      multicenter study.
PG  - 838-43
AB  - BACKGROUND: Large-scale clinical trials in children are lacking concerning 
      Helicobacter pylori eradication therapies. The purpose of this study was to 
      assess the efficacy of proton pump inhibitor (PPI)-based triple therapies in 
      Japanese children. METHODS: This was a retrospective analysis of the first- and 
      second-line PPI-based triple therapies from pediatric gastrointestinal units 
      between 1996 and 2003. Data collected included doses and duration of regimens, 
      drug compliance, success or failure of eradication, ulcer healing, and symptom 
      response of those with dyspepsia and no ulcers. The results of antibiotic 
      susceptibility tests were also reported in cases where these were performed. 
      RESULTS: A total of 149 pediatric patients (mean age, 12.6 years) were studied, 
      including 123 patients who received first-line therapy: 115 received a PPI plus 
      amoxicillin and clarithromycin (PAC) and 8 received a PPI plus amoxicillin and 
      metronidazole (PAM). Overall eradication rates of the first-line PAC and PAM 
      therapies were 77.4% and 87.5%, respectively ( P = 0.68). All 14 patients with 
      failed PAC therapy received the second-line PAM regimen, resulting in an 
      eradication rate of 100%. Mild side effects were reported only in PAC regimens 
      (13.8%). Primary resistance to amoxicillin, clarithromycin, and metronidazole was 
      detected in 0%, 34.7%, and 12.5% of the strains, respectively. The PAC regimen 
      showed a high eradication rate for clarithromycin-susceptible strains (91.7%), 
      but was relatively ineffective for resistant strains (40.0%) ( P < 0.01). 
      Eradication of H. pylori was associated with ulcer healing and symptomatic 
      improvement among those with gastritis only (both; P < 0.001). Among 17 patients 
      with iron-deficiency anemia, post-treatment hemoglobin levels were higher than 
      the pretreatment levels ( P < 0.001). CONCLUSIONS: The PAC regimen is effective 
      in children. Clarithromycin resistance is associated with eradication failure. 
      Metronidazole is a good substitute for clarithromycin as the second-line option 
      for children.
FAU - Kato, Seiichi
AU  - Kato S
AD  - Department of Pediatrics, Tohoku University School of Medicine, 1-1 Seiryo-machi, 
      Aoba-ku, 980-8574 Sendai, Japan.
FAU - Konno, Mutsuko
AU  - Konno M
FAU - Maisawa, Shun-Ichi
AU  - Maisawa S
FAU - Tajiri, Hitoshi
AU  - Tajiri H
FAU - Yoshimura, Norikazu
AU  - Yoshimura N
FAU - Shimizu, Toshiaki
AU  - Shimizu T
FAU - Toyoda, Shigeru
AU  - Toyoda S
FAU - Nakayama, Yoshiko
AU  - Nakayama Y
FAU - Iinuma, Kazuie
AU  - Iinuma K
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - Japan
TA  - J Gastroenterol
JT  - Journal of gastroenterology
JID - 9430794
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Benzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Sulfoxides)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - 140QMO216E (Metronidazole)
RN  - 32828355LL (Rabeprazole)
RN  - 804826J2HU (Amoxicillin)
RN  - D8TST4O562 (Pantoprazole)
RN  - H1250JIK0A (Clarithromycin)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Adolescent
MH  - Amoxicillin/therapeutic use
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Benzimidazoles/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Clarithromycin/pharmacology/therapeutic use
MH  - Drug Resistance, Microbial
MH  - Drug Therapy, Combination
MH  - Helicobacter Infections/*drug therapy
MH  - Humans
MH  - Infant
MH  - Lansoprazole
MH  - Metronidazole/pharmacology/therapeutic use
MH  - Microbial Sensitivity Tests
MH  - Omeprazole/*analogs & derivatives/therapeutic use
MH  - Pantoprazole
MH  - *Proton Pump Inhibitors
MH  - Rabeprazole
MH  - Retrospective Studies
MH  - Sulfoxides/therapeutic use
EDAT- 2004/11/27 09:00
MHDA- 2005/01/19 09:00
CRDT- 2004/11/27 09:00
PHST- 2003/10/02 00:00 [received]
PHST- 2004/02/13 00:00 [accepted]
PHST- 2004/11/27 09:00 [pubmed]
PHST- 2005/01/19 09:00 [medline]
PHST- 2004/11/27 09:00 [entrez]
AID - 10.1007/s00535-004-1398-6 [doi]
PST - ppublish
SO  - J Gastroenterol. 2004 Sep;39(9):838-43. doi: 10.1007/s00535-004-1398-6.