PMID- 32939900 OWN - NLM STAT- MEDLINE DCOM- 20210914 LR - 20210914 IS - 1523-5378 (Electronic) IS - 1083-4389 (Linking) VI - 25 IP - 6 DP - 2020 Dec TI - Efficacy of a novel sequential treatment regimen containing bismuth for Helicobacter pylori eradication in Turkish children. PG - e12757 LID - 10.1111/hel.12757 [doi] AB - BACKGROUND: Eradication rates of Helicobacter pylori (H pylori) with standard triple therapy are gradually decreasing all over the world, including in children, due to the development of strains resistant to antimicrobials. Sequential therapy can be used as an alternative method to increase eradication rates. MATERIALS AND METHODS: A total of 75 patients >/= 8 years of age with H pylori gastritis were included in the study. According to Rome IV criteria, 38 patients had functional abdominal pain and dyspepsia, and 37 patients had alarm findings suggesting organic disease. Patients were treated with a novel sequential therapy consisting of the proton pump inhibitor (PPI)-lansoprazole (1 mg/kg/day, maximum 30 mg daily), amoxicillin (50 mg/kg/d in two doses, maximum 2 x 1000 mg) for 7 days followed by PPI-lansoprazole (1 mg/kg/d, maximum 30 mg daily), metronidazole (20 mg/kg/day in two doses, maximum 2 x 500 mg), tetracycline (50 mg/kg/d divided into four equal doses, maximum 4 x 500 mg), and bismuth subsalicylate (262 mg QID in patients 10 years of age in days 8-14). Eradication status was evaluated by H pylori stool antigen test 8 weeks after the completion of treatment. RESULTS: The mean age of the patients was 15.1 +/- 2.4 years and 51 (68%) were female. No patient discontinued therapy due to side effects. All patients had antral gastritis (76.0%) or pangastritis (24.0%). The peptic ulcer rate was 6.6%. Eradication therapy was given to all patients with or without peptic ulcer. H pylori eradication was achieved in 69 (92.0%) patients and symptoms improved in 61 of those eradicated. CONCLUSIONS: As a first-line treatment for H pylori eradication in children, administering a novel sequential therapy including bismuth for 14 days provides a high rate of eradication. CI - (c) 2020 John Wiley & Sons Ltd. FAU - Arslan, Melike AU - Arslan M AUID- ORCID: 0000-0002-0107-4699 AD - Division of Pediatric Gastroenterology, Department of Pediatrics, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey. FAU - Balamtekin, Necati AU - Balamtekin N AD - Division of Pediatric Gastroenterology, Department of Pediatrics, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey. FAU - Gunal, Armagan AU - Gunal A AD - Department of Pathology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey. LA - eng PT - Journal Article DEP - 20200917 PL - England TA - Helicobacter JT - Helicobacter JID - 9605411 RN - 0 (Anti-Bacterial Agents) RN - 140QMO216E (Metronidazole) RN - 804826J2HU (Amoxicillin) RN - H1250JIK0A (Clarithromycin) RN - U015TT5I8H (Bismuth) SB - IM MH - Adolescent MH - Amoxicillin/therapeutic use MH - *Anti-Bacterial Agents/therapeutic use MH - *Bismuth/therapeutic use MH - Child MH - Clarithromycin/therapeutic use MH - Drug Therapy, Combination MH - Female MH - *Helicobacter Infections/drug therapy MH - Helicobacter pylori MH - Humans MH - Metronidazole/therapeutic use MH - Treatment Outcome MH - Turkey OTO - NOTNLM OT - Helicobacter pylori OT - bismuth OT - childhood gastritis OT - eradication therapy EDAT- 2020/09/18 06:00 MHDA- 2021/09/15 06:00 CRDT- 2020/09/17 05:49 PHST- 2020/06/07 00:00 [received] PHST- 2020/08/22 00:00 [revised] PHST- 2020/08/25 00:00 [accepted] PHST- 2020/09/18 06:00 [pubmed] PHST- 2021/09/15 06:00 [medline] PHST- 2020/09/17 05:49 [entrez] AID - 10.1111/hel.12757 [doi] PST - ppublish SO - Helicobacter. 2020 Dec;25(6):e12757. doi: 10.1111/hel.12757. Epub 2020 Sep 17.