Evaluation Of Two Triple-Therapy Regimens With Metronidazole Or Clarithromycin For The Eradication Of H-Pylori Infection In Vietnamese Children: A Randomized, Double-Blind Clinical Trial

HELICOBACTER(2008)

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摘要
Eradication of Helicobacter pylori infection in children in developing countries needs further investigations upon which to base treatment recommendations. The aim of the study was to compare two 2-week triple therapies in a randomized double-blind trial.In order not to exceed recommended dosages, the 238 H. pylori-infected children, aged 3 to 15 years (mean 8.6), were divided in two weight categories receiving at weights 13-22 kg: lansoprazole 15 mg once-daily and amoxicillin 500 mg twice-daily with metronidazole 250 mg twice-daily or clarithromycin 250 mg once-daily; at weights 23-45 kg: lansoprazole 15 mg and amoxicillin 750 mg with metronidazole 500 mg or clarithromycin 250 mg, all administered twice daily. H. pylori status was assessed by culture and a monoclonal-based antigen-in-stool test (Premier Platinum HpSA PLUS) and side effects by structured questionnaires.The overall per-protocol eradication (n = 233) was similar in the two treatment regimens, 62.1% for the metronidazole and 54.7% for the clarithomycin-containing therapy. Eradication rate was higher in children >= 23 kg (70.9%) than in children < 23 kg (45.7%). In children >= 23 kg (n = 117) that received twice-daily administration of all drugs, efficacy of the methronidazole and clarithromycin-containing treatments were 69.5% and 72.4%, respectively.The two treatments gave similar eradication rates. Significant differences for both treatments were found by weight, which could be the result of the once-daily proton pump inhibitor and clarithromycin and/or more antibiotic resistant strains in younger children.
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关键词
Helicobacter pylori, triple therapy, clarithromycin, metronidazole, children, developing country
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