The currently recommended efficacy of first line eradication Helicobacter pylori in children is around 75%. Studies conducted in recent years have shown greater effectiveness in the use of the new 10-day consecutive treatment regimen in adult patients (95% eradication rate).

The aim of a randomized study by R. Francavilla et al. (Italy), an evaluation was made of the frequency of eradication of H. pylori when using a sequential treatment regimen compared to the standard three-component regimen in children. The study included 75 children infected with H. pylori; 38 of them (average age 11 years) received sequential treatment, 37 (average age 9.9 years) received standard three-component treatment. The diagrams used are presented in the table:

Patients in the two groups did not differ significantly by sex, age, clinical manifestations of the disease, presence of anti-CagA antibodies, results of endoscopic and histological studies. Infection with H. pylori was confirmed by positive results in 2 of the 3 tests: 13C urease breath test, rapid urease test and histological examination. Eradication was assessed using a 13C urease breath test 8 weeks and 6 months after treatment was completed.

Eradication of H. pylori was achieved in 36 children who received sequential therapy (97.3%; 95% confidence interval (CI) 86.2-99.5) and 28 children who received three-component therapy (75.7%; 95% CI 59.8-86.7; P less than 0.02). Compliance was acceptable in both treatment groups (greater than 95%). The study did not find any serious adverse events. Significant differences in the incidence of adverse events (short-term abdominal pain, nausea, diarrhea) in the two groups (13.5% in the consecutive treatment group and 10.8% in the triple therapy group) did not also not been observed.

Thus, the study showed for the first time that a consecutive 10-day therapy achieves a higher eradication rate than standard three-component therapy in children.