ABSTRACT: AIM:: The aim of this study was to compare the efficacy of sequential and standard triple-drug regimen for Helicobacter pylori (H. pylori) eradication in children and to determine the primary resistance rate to clarithromycin. PATIENTS AND METHODS:: Children with H. pylori infection randomized to receive either standard regimen (n=28) consisting of lansoprazole for 30 days, amoxicillin and clarithromycin for 14 days or sequential regimen (n = 16) consisting of lansoprazole for 30 days, amoxicillin for 7 days, followed by clarithromycin and metronidazole for the next 7 days. Clarithromycin susceptibility of H. pylori was assessed with fluorescence in-situ hybridization technique. Eradication was controlled by C urea breath test or monoclonal stool antigen test 4 weeks after the end of the therapy. RESULTS:: Helicobacter pylori eradication rate was higher in the sequential therapy group (93.7%), compared to the standard therapy group (46.4%) (p = 0.002). There was no difference in adverse drug reactions and in compliance to the treatment between the groups. Primary clarithromycin resistance rate for H. pylori was found as 25.7% (n = 9). All of the patients having clarithromycin resistance were coincidentally in the standard therapy group. After the exclusion of these nine patients, sequential therapy was again found to be more effective than the standard therapy (p = 0.02). CONCLUSIONS:: Sequential therapy seems highly effective for the eradicating H. pylori in children. However the difference between two group in resistant strains was the limitation of the study. Our country needs to reassess the effectiveness of standard triple therapy regimen for H. pylori eradication.
Journal of pediatric gastroenterology and nutrition 03/2012; · 2.18 Impact Factor