Management of Helicobacter pylori infection in paediatric patients in Europe: results from the EuroPedHp Registry

Autor: 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, Sykora, Josef, Miele, Erasmo, Krahl, Andreas, Klemenak, Martina, Papadopoulou, Alexandra, Chiaro, Andrea, Ugras, Meltem Korkut, de Laffolie, Jan, Matusiewics, Krzysztof, Rea, Francesca, Casswall, Thomas, Roma, Eleftheria, Banoub, Hany, Cseh, Aron, Rogalidou, Maria, Lopes, Ana Isabel, Thi, Thu Giang Le
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Infection, Heidelberg : Springer, 2022, first on line, p. [1-14]
ISSN: 0300-8126
1439-0973
Popis: 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.
Databáze: OpenAIRE
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