HIGH-DOSE AMOXICILLIN FOR H. PYLORI GASTRITIS IN CHILDREN: A CASE-SERIES STUDY
Nội dung chính của bài viết
Tóm tắt
Objective: To evaluate the efficacy and safety of a high-dose Amoxicillin regimen in the treatment of gastritis associated with Helicobacter pylori (H. pylori) infection in children in Vietnam.
Subjects and methods: A cross-sectional descriptive study was conducted on 50 pediatric patients under 16 years of age (mean age 7.46 ± 3.01 years) diagnosed with first-time H. pylori-associated gastritis and treated at Thanh Hoa Pediatric Hospital. The treatment regimen included high-dose Amoxicillin (75-100 mg/kg/day, divided into two doses for 2 weeks) combined with other antibiotics and a proton pump inhibitor (PPI).
Results: After treatment, significant improvements were observed in clinical symptoms: abdominal pain decreased from 100% to 36%, vomiting and nausea from 60% to 8%, belching and acid reflux from 24% to 2%, and bloating and indigestion from 14% to 2%. Minimal adverse events were reported, with abdominal pain in 4% of cases and vomiting or diarrhea in 2%. The eradication rate of H. pylori was 44%.
Conclusion: The high-dose Amoxicillin regimen improved clinical symptoms in children with H. pylori-associated gastritis. However, the low eradication rate suggests a high prevalence of Amoxicillin resistance in Vietnam. Further studies with larger sample sizes and a control group are needed to identify more effective treatment strategies tailored to local antibiotic resistance patterns.
Chi tiết bài viết
Từ khóa
gastritis, Amoxicillin, Helicobacter pylori, treatment outcome, children
Tài liệu tham khảo
[2] Nguyen TC, Tang NLC, Le GKN, Nguyen VT, Nguyen KHG, Che TH, Phan VTT, Nguyen NM, Truong DQ, Ngo XM, Nguyen HT, Robert A, Bontems P, Nguyen PNV. Helicobacter pylori Infection and Peptic Ulcer Disease in Symptomatic Children in Southern Vietnam: A Prospective Multicenter Study. Healthcare (Basel). 2023 Jun 5;11(11):1658. doi: 10.3390/healthcare11111658. PMID: 37297795; PMCID: PMC10253129.
[3] V. V. Khien, D. M. Thang, T. M. Hai, N. Q. Duat, P. H. Khanh, D. T. Ha, T. T. Binh, H. D. Q. Dung, T. T. H. Trang, Y. Yamaoka, “Management of Antibiotic-Resistant Helicobacter pylori Infection: Perspectives from Vietnam”, Gut Liver, 13 (5): 483-497, 2019.
[4] T. V. Nguyen, C. Bengtsson, L. Yin, G. K. Nguyen, T. T. Hoang, D. C. Phung, M. Sörberg, M. Granström, “Eradication of Helicobacter pylori in children in Vietnam in relation to antibiotic resistance”, Helicobacter, 17 (4): 319-25, 2012.
[5] T. U. Wheeldon, M. Granström, T. T. Hoang, D. C. Phuncarg, L. E. Nilsson, M. Sörberg, “The importance of the level of metronidazole resistance for the success of Helicobacter pylori eradication”, Aliment Pharmacol Ther, 19:1315–1321, 2004.
[6] N. L. Jones, S. Koletzko, K. Goodman, P. Bontems, S. Cadranel, T. Casswall, S. Czinn, B. D. Gold, J. Guarner, Y. Elitsur, M. Homan, N. Kalach, M. Kori, A. Madrazo, F. Megraud, A. Papadopoulou, M. Rowland; ESPGHAN, NASPGHAN, “Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)”, J Pediatr Gastroenterol Nutr., 64 (6): 991-1003, 2017.
[7] H. V. Thieu, N. M. Duc, B. T. D. Nghi, N. V. Bach, H. H. Khoi, V. N. T. Tien, M. T. L. Bang, T. L. C. Ngoc, “Antimicrobial Resistance and the Successful Eradication of Helicobacter pylori-Induced Gastroduodenal Ulcers in Vietnamese Children”, Med Arch, 75(2):112-115, 2021.
[8] Meliț LE, Mărginean CO, Săsăran MO. The Challenges of Eradicating Pediatric Helicobacter pylori Infection in the Era of Probiotics. Children (Basel). 2022;9(6):795. Published 2022 May 28. doi:10.3390/children9060795
[9] Chakravarty K, Gaur S. Role of Probiotics in Prophylaxis of Helicobacter pylori Infection. Curr Pharm Biotechnol. 2019;20(2):137-145. doi: 10.2174/1389201020666190227203107. PMID: 30827235.
[10] Ünlüsoy Aksu A, Yılmaz G, Eğritaş Gürkan Ö, Sarı S, Dalgıç B. The effect of Helicobacter pylori eradication on functional dyspepsia in Turkish children. Helicobacter. 2018 Aug;23(4):e12497. doi: 10.1111/hel.12497. Epub 2018 Jun 6. PMID: 29873438.
[11] Nyssen OP, Perez-Aisa A, Tepes B et al. Adverse Event Profile During the Treatment of Helicobacter pylori: A Real-World Experience of 22,000 Patients From the European Registry on H. pylori Management (Hp-EuReg). Am J Gastroenterol. 2021 Jun 1;116(6):1220-1229. doi: 10.14309/ajg.0000000000001246. PMID: 33840725.
[12] Manfredi M, Gargano G, Gismondi P, Ferrari B, Iuliano S. Therapeutic eradication choices in Helicobacter pylori infection in children. Therap Adv Gastroenterol. 2023;16:17562848231170052. Published 2023 Apr 27. doi:10.1177/17562848231170052