Quadruple therapy for Helicobacter pylori eradication in children and adolescents with peptic ulcers and/or erosions of the gastroduodenal zone

Abstract

Objectives and Study: Increasing antibiotic resistance leads to a decrease in the effectiveness of traditional Helicobacter pylori (Hp) eradication regimens. This problem is especially relevant in Ukraine (population‐wide resistance to CLA is 17‐22%). Objective: to evaluate the effectiveness of quadruple therapy regimens PPI + A + M+Bi of different duration and dosage and to analyze compliance in the treatment of HP‐associated ulcers and/or erosions in children living in the frontline area. Methods: 85 school‐age children (mean age 13.7 ± 2.42 years) with Hp‐associated erosions and ulcers were observed. Hp infection diagnosed by biopsy and/or antigenic stool test before and after eradication. All patients prescribed basic quadruple therapy PPI + A + M+Bi according to ESPGHAN 2016, 2023 recommendations and divided into 3 groups. Group 1 (25 people) ‐ quadruple therapy in a standard dose for 10 days, group 2 (30 people) ‐ PPI + A (in high doses)+M+Bi for 10 days, group 3 (30 people) ‐ PPI + A + M+Bi in a standard dose for 14 days. Patients filled out the corresponding ESPGHAN flyers, which analyzed during and after the treatment. The results were statistically processed. Results: The effectiveness of quadruple therapy in patients in group 1 was 76%. Side effects (nausea, diarrhea, allergic reactions) were minimal in 2 patients (8%), compliance was maximum (100%). The effectiveness of eradication in patients in group 2 was 93.3%, side effects in 5 patients (16.7%), there were no refusals from therapy, compliance was high. The effectiveness of eradication in group 3 was 83.3%, side effects in 6 children (20%) and the largest number (12!) of violations of recommendations up to self‐termination of treatment, compliance was low. It was the failure to comply with recommendations that negatively affected the effectiveness of eradication. Conclusions: Quadruple therapy PPI + A + M+Bi (with high dose PPI + A) for 10 days is optimal and effective for the treatment of Hр in children with high CLA resistance and in adverse war conditions.