P3.M252: Different regimens for eradication of helicobacter pylori infection in children: a randomized cont

Background: The choice of a proper initial H. pylori eradication therapy is usually a difficult task, especially in developing countries where high rates of antibiotic resistance are found.

Aim: to compare the efficacy and safety of triple therapy (TT), sequential therapy (ST), hybrid therapy (HT), concomitant therapy (CT) and ciprofloxacin-based triple therapy (CTT) as first-line therapy for H. pylori eradication in children.

Methods: This randomized controlled trial was conducted on 200 children (aged between 3 and 16 years) who underwent upper endoscopy at Endoscopy Unit of Alexandria University Children’s Hospital (AUCH), EgyptIn . The diagnosis of H pylori infection was confirmed by positive rapid urease test and histopathological detection of the organism in gastric biopsies . Patients were randomly assigned to receive either TT, ST, HT, CT, or CTT. The eradication status was evaluated using a stool antigen test at least 4 weeks after the stoppage of antibiotic therapy. This study was registered at

the Pan African Clinical Trials Registry, Cochrane South Africa, under the identifier PACTR202201686010590.

Results: The most common presenting symptom was epigastric pain (79%). The most common endoscopic findings were gastric antral erythema (98%) and antral nodularity (54.5%). Seventy-five percent of the cases had histopathological chronic active gastritis. The eradication rates for TT, ST, HT, CT, and CTT were 70%, 77.5%, 80%, 85%, and 90%, respectively, with the latter achieving a statistically significant difference when compared to TT (p = 0.025). The rate of occurrence of adverse effects among different regimens was not statistically different.

Conclusion: for children with H. pylori infection, CTT appear safe in children and provides the highest eradication rate followed by CT . the eradication rates of HT and ST did not exceed 80% .TT showed the lowest rate of eradication.