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.