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Grażyna Bała, Grażyna Mierzwa, Mieczysława Czerwionka-Szaflarska, Anna Szaflarska-Szczepanik
Med Sci Monit 1999; 5(5): CR885-890
The aim of the present work was to compare the efficiency and tolerance of two therapies applied for the treatment of H. pylori infection in children with gastritis and duodenitis and chronic duodenal ulcer disease. 153 test subjects (aged 7-17 years) with gastritis and duodenitis as well as chronic ulcer disease and H.p. infection took part in the study. The children received two different types of therapy.Scheme I (94 children aged 7-12 years): Bismuth citrate (8 mg/kg/day in 4 doses for 6 weeks), Amoxicillin (50 mg/kg/day in 3 doses for 2 weeks), Metronidazole (20 mg/kg/day in 3 doses for 2 weeks). Scheme II (59 children aged 10-17 years, body mass > 35 kg): Pantoprazole (2x40 mg in 2 doses), Clarithromycin (15 mg/kg/day in 2 doses), Metronidazole (20 mg/kg/day in 2 doses) for 7 days. In patients with duodenal ulcer treated according to scheme II, the therapy was continued with 1x40 mg pantoprazole for the following 14 days. Clinical, endoscopic and histological assessment of treatment efficiency was performed. The presence of H.p. infection was determined before and 4-6 weeks after the completion of treatment.
Results: H.p. eradication with the regression of clinical symptoms,macroscopic and histological improvement of mucosa and the healing of duodenal ulcer was obtained in 85% children treated according to scheme I. As far as scheme II is concerned, eradication of H.p. infection together with clinical, macroscopic and histological improvement as well as the healing of ulceration in duodenal bulb was observed in 93% children. Adverse reactions such as headache, nausea, mycosis were recorded only in 2.8% children treated according to scheme I.The comparative analysis performed by our team showed the superiority of scheme II due to its high efficiency in the treatment of duodenal ulcer, large extent of H.p. eradication, good tolerance and short therapy duration.
key words: Helicobacter pylori, children, treatment, pantoprazole,clarithromycin