Results from the Pediatric European Register for Treatment of Helicobacter pylori (PERTH)

Abstract

European pediatricians entering data in the register used 27 different regimens. Bismuth-containing therapies resulted in higher eradication rate. Omeprazole-containing triple therapies were the most used although their efficacy was low. Therapies recommended for adults do not appear to be suitable for children.

Helicobacter pylori—Associated Dyspepsia in Paediatrics

“…But, the prevalence of H. pylori-positive ulcers in children also differs between countries and this is not completely explained by the prevalence of the infection in the population studied. This is easily demonstrated from data collected from January 2001 to December 2002 on 518 children from the paediatric European register for treatment of H. pylori [5]. At endoscopy, 454 of those patients had H. pylori-associated gastritis and 64 had a peptic ulcer (12.3%).…”

“…Nevertheless, H. pylori-associated peptic ulcer disease may also occur shortly after infection in childhood [4][5][6][7][8]. This rare event may be due to more virulent strains [9][10][11][12][13][14][15][16], and/or more predisposed subjects [17][18][19].…”

“…[95]. Despite changing prevalence trends, H. pylori-induced gastritis causing mucosal ulceration either in the stomach (gastric ulcer) or the proximal duodenum (duodenal ulcer) is a relatively uncommon event in children, compared with adults [4][5][6][7][8]. In fact, during childhood, H. pylori is associated with predominant antral gastritis or with pangastritis [96].…”

“…In fact, during childhood, H. pylori is associated with predominant antral gastritis or with pangastritis [96]. In children, few studies have yet investigated the actual trend of H. pylori prevalence in peptic ulcer disease [5][6][7][8] and the available data are more difficult to interpret, considering that the rates of peptic ulcer diagnosis depend also on the clinical setting (endoscopy versus outpatient clinic or hospital admissions) [97,98]. For example, in Italy the detection rate of ulcer disease was 7.8% out of an average of 180 paediatric gastrointestinal endoscopies performed each year [99].…”

“…If often asymptomatic, the H. pylori-associated non-ulcer dyspepsia is clearly the strongest aetiological factor for severe gastric diseases that will develop late in adult life in a minority of infected patients, i.e., peptic ulcer disease, both gastric and duodenal ulcers, and gastric cancer, namely, adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma (reviewed in [3]). Peptic ulcer disease rarely occurs soon after H. pylori infection [4][5][6][7][8] that generally starts in childhood; this presumably reflects marked differences in the virulence [9][10][11][12][13][14][15][16] and/or in the susceptibility of young patients [17][18][19].…”