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RESULTS OF MULTICENTRE PROSPECTIVE RANDOMISED TRIAL OF HELICOBACTER PYLORI ERADICATION: NITROFURAN-BASED TRIPLE THERAPY VERSUS METRONIDAZOLE-BASED TRIPLE THERAPY
  1. A Logvinova1,
  2. P L Shcherbakov2,
  3. S I Erdes1,
  4. M Yu Shcherbakova3,
  5. A Aminova4,
  6. R Faisullina5,
  7. E Kornienko6,
  8. D Passetchnikov7
  1. 1Moscow Medicine Academy IM Sechenova, Moscow, Russia,
  2. 2Central Institution of Gastroenterology of Moscow, Moscow, Russia,
  3. 3Russian State Medicine University, Moscow, Russia,
  4. 4Perm Regional Scientific Research Institute, Perm, Russia,
  5. 5Kazan State Medicine Academy, Kazan, Russia,
  6. 6Saint-Petersburg State Pediatric Medicine Academy, St Petersburg, Russia,
  7. 7Stavropol State Medicine Academy, Stavropol, Russia

Abstract

Introduction: The main reason for antibacterial therapy inefficiency is currently considered to be the increase in Helicobacter pylori resistance to antibacterial drugs of standard triple therapy.

Aims and Methods: Aim of the study was to compare the efficacy and tolerability of two dosage different first-line nifuroxazid, metronidazole-based schemes for the eradication of H pylori infection in paediatrics. We enrolled 225 children (7–17 years of age: 106 girls and 119 boys) with stomach and duodenum H pylori infections. Patients underwent 13C urea breath test, upper endoscopy, histology, rapid urease test. Upper endoscopy was assessed before treatment and 8 weeks after the end of therapy. Patients were randomly assigned into group A: lansoprazole 60 mg/day, clarithromycin 500 mg/day (ages 7–12 years), 1000 mg/day (ages 12–17 years), enterofuril suspension 400 mg/day (ages 7–12 years) and 800 mg/day (ages 12–17 years) and group B: lansoprazole 60 mg/day, clarithromycin 500 mg/day (ages 7–12 years), 1000 mg/day (ages 12–17 years), metronidazole 500 mg/day (ages 7–12 years), 1000 mg/day (ages 12–17 years), each administered twice a day.

Results: All 225 patients finished anti-H pylori therapy in both groups. Eradication rates were: group A 70%, p = 0.036 (enterofuril 400 mg/day 66%, p = 0.067, 800 mg/day 87.5%, p = 0.047), group B 46%, p = 0.064. Mild side effects (nausea, diarrhoea, allergic eruption) were reported in 12 patients. No severe adverse events were observed.

Conclusion: Nitrofuran-based triple therapy is more effective than metronidazole-based triple therapy for the eradication of H pylori in children.

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