Published online Aug 28, 2020. doi: 10.13105/wjma.v8.i4.292
Peer-review started: July 29, 2020
First decision: August 22, 2020
Revised: August 28, 2020
Accepted: August 28, 2020
Article in press: August 28, 2020
Published online: August 28, 2020
Processing time: 43 Days and 8.7 Hours
Helicobacter pylori (H. pylori) infection is predominantly acquired in childhood. When indicated, the most accepted treatment for H. pylori eradication in this age group is first-line triple therapy. However, the increasing resistance to clarithromycin and nitroimidazoles has been associated with treatment failure, and thus, alternative treatment regimens have been proposed.
To perform a systematic review of randomized controlled trials on treatment regimens for H. pylori infection in children.
We surveyed relevant articles published in English from 2010 to April 2020 in the PubMed and MEDLINE databases. Keywords included “Helicobacter pylori”/”children or childhood”/”treatment or eradication.” The risk of bias was evaluated according to the Cochrane Handbook of Systematic Reviews for Interventions.
Among the 1144 records identified through the database, 20 articles were selected. Four studies compared the eradication rates of H. pylori infection between standard triple therapies, changing only the main antibiotic used. Seven studies evaluated the effectiveness of standard triple therapy with the addition of probiotics. One study investigated the relationship between the effectiveness in the eradication rates of standard triple therapy and vitamin E levels. Six studies analyzed the eradication rates of sequential therapy.
The findings suggest that although standard triple therapy is the most recommended regimen for children by the current guidelines, other therapeutic schemes have shown promising results and may also be recommended for clinical practice in the future.
Core Tip: Helicobacter pylori (H. pylori) is a bacterium that infects more than 50% of the population worldwide. In the last several years, no significant changes in the treatment of infected children have been observed, mainly due to a lack of studies with satisfactory scientific evidence to support the indication of therapies in clinical practice. We performed a systematic review of randomized controlled trials on treatment regimens for H. pylori infection in children.