Efficacy of Bismuth Therapy in Eradicating Helicobacter pylori in Children—Data From the RENIHp Registry

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2024-10-09 DOI:10.1111/hel.13142

Gonzalo Botija, Gonzalo Galicia, Beatriz Martínez, Carmen Cuadrado, Marta Soria, Sonia Fernández, Pedro Urruzuno, María-Luz Cilleruelo, SEGHNP H. pylori Working Group

{"title":"Efficacy of Bismuth Therapy in Eradicating Helicobacter pylori in Children—Data From the RENIHp Registry","authors":"Gonzalo Botija, Gonzalo Galicia, Beatriz Martínez, Carmen Cuadrado, Marta Soria, Sonia Fernández, Pedro Urruzuno, María-Luz Cilleruelo, SEGHNP H. pylori Working Group","doi":"10.1111/hel.13142","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To evaluate the efficacy of colloidal bismuth subcitrate (CBS) therapy for the eradication of <i>H. pylori</i> in patients from a national pediatric registry of <i>H. pylori</i> infection.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The Spanish Registry of Children with <i>H. pylori</i> Infection (RENIHp) is a national, multi-center, prospective, non-interventional registry that includes children aged 5–18 years with <i>H. pylori</i> infection diagnosed by endoscopy. All patients in the registry who were treated with CBS between the period 2020 and 2023 were included in this study. The primary outcome was the eradication rate, which was assessed using a <sup>13</sup>C-urea breath test or monoclonal antigen in the stool 6–8 weeks post-treatment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The registry included 682 patients, 38 (5.6%) of whom underwent treatment with CBS. Fifty percent (19/38) of patients had previously undergone unsuccessful eradication treatment. In 78.9% (30/38) of patients, treatment was guided by an antibiotic sensitivity test. In the remaining patients, an empirical approach was employed. The CBS therapies used were as follows: quadruple therapy with proton pump inhibitors (PPIs), CBS, amoxicillin, and metronidazole (MET) [18/38 (47.3%)]; quadruple therapy with PPIs, CBS, tetracycline, and MET [13/38 (34.2%)]; and other therapies [7/38 (18.4%)]. Thirty-two patients (84.2%) treated with CBS were followed-up with eradication monitoring. The overall eradication rate in patients treated with CBS was 93.8% (30/32, [95% CI: 85.4%–100%]), whereas it was 86.7% in patients in the registry who were not on CBS treatment (430/496, [95% CI: 83.3%–89.5%], <i>p</i> = 0.208). In the six patients with dual resistance to clarithromycin (CLA) and MET who were treated with quadruple therapy with CBS, the eradication rate was 100% (<i>n</i> = 6/6, [95% CI: 61.0%–100%]).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>CBS therapies in our registry, although only used in selected cases and at lower than recommended levels, were very effective and showed an eradication rate of > 90%.</p>\n </section>\n </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Helicobacter","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hel.13142","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

To evaluate the efficacy of colloidal bismuth subcitrate (CBS) therapy for the eradication of H. pylori in patients from a national pediatric registry of H. pylori infection.

Methods

The Spanish Registry of Children with H. pylori Infection (RENIHp) is a national, multi-center, prospective, non-interventional registry that includes children aged 5–18 years with H. pylori infection diagnosed by endoscopy. All patients in the registry who were treated with CBS between the period 2020 and 2023 were included in this study. The primary outcome was the eradication rate, which was assessed using a ¹³C-urea breath test or monoclonal antigen in the stool 6–8 weeks post-treatment.

Results

The registry included 682 patients, 38 (5.6%) of whom underwent treatment with CBS. Fifty percent (19/38) of patients had previously undergone unsuccessful eradication treatment. In 78.9% (30/38) of patients, treatment was guided by an antibiotic sensitivity test. In the remaining patients, an empirical approach was employed. The CBS therapies used were as follows: quadruple therapy with proton pump inhibitors (PPIs), CBS, amoxicillin, and metronidazole (MET) [18/38 (47.3%)]; quadruple therapy with PPIs, CBS, tetracycline, and MET [13/38 (34.2%)]; and other therapies [7/38 (18.4%)]. Thirty-two patients (84.2%) treated with CBS were followed-up with eradication monitoring. The overall eradication rate in patients treated with CBS was 93.8% (30/32, [95% CI: 85.4%–100%]), whereas it was 86.7% in patients in the registry who were not on CBS treatment (430/496, [95% CI: 83.3%–89.5%], p = 0.208). In the six patients with dual resistance to clarithromycin (CLA) and MET who were treated with quadruple therapy with CBS, the eradication rate was 100% (n = 6/6, [95% CI: 61.0%–100%]).

Conclusion

CBS therapies in our registry, although only used in selected cases and at lower than recommended levels, were very effective and showed an eradication rate of > 90%.

查看原文本刊更多论文

铋疗法根除儿童幽门螺旋杆菌的疗效--来自 RENIHp 登记处的数据。

目的方法：西班牙幽门螺杆菌感染儿童登记处（RENIHp）是一个全国性的多中心前瞻性非介入性登记处：西班牙幽门螺杆菌感染儿童登记处（RENIHp）是一个全国性、多中心、前瞻性、非干预性登记处，登记对象包括经内镜检查确诊为幽门螺杆菌感染的 5-18 岁儿童。本研究纳入了登记册中 2020 年至 2023 年期间接受 CBS 治疗的所有患者。主要结果是根除率，通过13C-尿素呼气试验或治疗后6-8周粪便中的单克隆抗原进行评估：登记包括 682 名患者，其中 38 人（5.6%）接受了 CBS 治疗。50%的患者（19/38）曾接受过不成功的根除治疗。78.9%的患者（30/38）是在抗生素敏感性测试的指导下接受治疗的。其余患者则采用经验疗法。使用的 CBS 疗法如下：质子泵抑制剂 (PPI)、CBS、阿莫西林和甲硝唑 (MET) 四联疗法 [18/38 (47.3%)]；PPI、CBS、四环素和 MET 四联疗法 [13/38 (34.2%)]；其他疗法 [7/38 (18.4%)]。接受 CBS 治疗的 32 名患者（84.2%）接受了根除监测随访。接受 CBS 治疗的患者的总根除率为 93.8%（30/32，[95% CI：85.4%-100%]），而未接受 CBS 治疗的登记患者的总根除率为 86.7%（430/496，[95% CI：83.3%-89.5%]，P = 0.208）。对克拉霉素（CLA）和 MET 双耐药的 6 名患者接受了 CBS 四联疗法，根除率为 100%（n = 6/6，[95% CI：61.0%-100%]）：结论：在我们的登记中，CBS疗法虽然仅用于部分病例，且使用量低于推荐水平，但非常有效，根除率大于90%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.