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KMID : 0816119980010010037
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Korean Journal of Pediatric Gastroenterolology and Nutrition
1998 Volume.1 No. 1 p.37 ~ p.44
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Therapeutic Outcome and Recurrence Rate of Helicobacter pylori Infection in Children
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Choi Won-Jun
Chung Ki-Sup
Kim Je-Woo
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Abstract
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Purpose: This study aimed at evaluating the therapeutic outcome, cost effectiveness
and recurrence rate in children with H. pylori infection after the treatment using various
medications.
Methods: Seventy five children (mean age 11.4±2.5 years) were given an endoscopy
with biopsy and H. pylori status assessed by CLO test and histologic examination
(Warthin Starry stain). Children were given one of following medications such as DA
(DenolR and amoxycillin), OA (omeprazole and amoxycillin), DC
(DenolR and clarithromycin) as primary treatment. And one of following
medications such as DAM (DenolR, amoxycillin and metronidazole), DC,
OA, OC (omeprazole and clarithromycin) were used in children who failed the
eradication of H. pylori.
Results: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9),
duodenal ulcer (6), superficial gastritis (6), and normal (8). If. H. pylori eradication rate
was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had
treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily)
and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all
of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had
not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was
re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in
remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4
of 75 children between 3 months and 3 years after completion of the treatment of DA,
yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was
re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2
cases, H. pylori infection persisted.
Conclusion: These results suggest that dual therapy with DenolR and
amoxycillin is the effective medications in treating H. pylori infection in children.
Concerning the cost effectiveness, it can be recommended as first line treatment of
choice as well.
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KEYWORD
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Treatment, Recurrence, Helicobacter pylori, Children,
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