Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry.
Purpose: The EuroPedHp-registry aims to monitor guideline-conform management, antibiotic resistance, and eradication success of 2-week triple therapy tailored to antibiotic susceptibility (TTT) in Helicobacter pylori-infected children. Methods: From 2017 to 2020, 30 centres from 17 European countrie...
| Published in: | Infection Vol. 51; no. 4; pp. 921 - 935 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Aug2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164982758&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 164982758 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Aug2023 vid: 51 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 164982758 160015766 164982758 164982758 10.1007/s15010-022-01948-y 164982758 ppf: 921 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry. aug: au: Le Thi, Thu Giang Werkstetter, Katharina Kotilea, Kallirroi Bontems, Patrick Cabral, José Cilleruelo Pascual, Maria Luz Kori, Michal Barrio, Josefa Homan, Matjaž Kalach, Nicolas Lima, Rosa Tavares, Marta Urruzuno, Pedro Misak, Zrinjka Urbonas, Vaidotas Koletzko, Sibylle for the Helicobacter pylori Special Interest Group of ESPGHAN Sykora, Josef Miele, Erasmo Krahl, Andreas affil: Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337, Munich, Germany sug: subj: Helicobacter Pylori In Infancy and Childhood Helicobacter Infections Drug Therapy Drug Therapy, Combination Guideline Adherence Evaluation Drug Resistance, Microbial Evaluation Disease Eradication Evaluation Treatment Outcomes Evaluation Human Male Female Child Adolescence Europe Funding Source National Health Programs Logistic Regression Bismuth Therapeutic Use Metronidazole Administration and Dosage Proton Pump Inhibitors Administration and Dosage Amoxicillin Administration and Dosage Clarithromycin Administration and Dosage Confidence Intervals Registries, Disease Odds Ratio Patient Compliance Descriptive Statistics Treatment Failure Evaluation Child: 6-12 years Adolescent: 13-18 years Male Female ab: Purpose: The EuroPedHp-registry aims to monitor guideline-conform management, antibiotic resistance, and eradication success of 2-week triple therapy tailored to antibiotic susceptibility (TTT) in Helicobacter pylori-infected children. Methods: From 2017 to 2020, 30 centres from 17 European countries reported anonymized demographic, clinical, antibiotic susceptibility, treatment, and follow-up data. Multivariable logistic regression identified factors associated with treatment failure. Results: Of 1605 patients, 873 had follow-up data (53.2% female, median age 13.0 years, 7.5% with ulcer), thereof 741 (85%) treatment naïve (group A) and 132 (15%) after failed therapy (group B). Resistance to metronidazole was present in 21% (A: 17.7%, B: 40.2%), clarithromycin in 28.8% (A: 25%, B: 51.4%), and both in 7.1% (A: 3.8%, B: 26.5%). The majority received 2-week tailored triple therapy combining proton pump inhibitor (PPI), amoxicillin with clarithromycin (PAC) or metronidazole (PAM). Dosing was lower than recommended for PPI (A: 49%, B: 41%) and amoxicillin (A: 6%, B: 56%). In treatment naïve patients, eradication reached 90% (n = 503, 95% CI 87–93%) and 93% in compliant children (n = 447, 95% CI 90–95%). Tailored triple therapy cured 59% patients after failed therapy (n = 69, 95% CI 48–71%). Treatment failure was associated with PAM in single clarithromycin resistance (OR = 2.47, 95% CI 1.10–5.53), with PAC in single metronidazole resistance (OR = 3.44, 95% CI 1.47–8.08), and with low compliance (OR = 5.89, 95% CI 2.49–13.95). Conclusions: Guideline-conform 2-weeks therapy with PPI, amoxicillin, clarithromycin or metronidazole tailored to antibiotic susceptibility achieves primary eradication of ≥ 90%. Higher failure rates in single-resistant strains despite tailored treatment indicate missed resistance by sampling error. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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