Safety of first-line triple therapy with a potassium-competitive acid blocker for Helicobacter pylori eradication in children
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Helicobacter pylori infection is a risk factor for gastric cancer, and it has been reported that eradication of H. pylori is effective for preventing such cancer. Recently, H. pylori eradication has been performed in children as first-line therapy against gastric cancer. Here, we report use of triple therapy with a potassium-competitive acid blocker (P-CAB) for H. pylori eradication in children.
H. pylori infection testing and eradication therapy began in fiscal year 2015 in junior high school students located in Yurihonjo city and Nikaho city, Akita prefecture, Japan. Urine-based immunochromatography, stool antigen enzyme-linked immunosorbent assay tests, and serum antibody tests were performed as the initial screening examination. Those who tested positive on one of the three examinations then underwent a urea breath test (13C-UBT). Those who tested positive on 13C-UBT and expressed the desire to undergo H. pylori eradication then received eradication therapy comprising 20 mg P-CAB, 750 mg amoxicillin, and 200 mg clarithromycin twice a day for 7 days. At least 8 weeks after treatment, eradication success was evaluated using 13C-UBT.
A total of 118 students received eradication therapy. Eradication rates were 81.3% (95% confidence interval: 74.3–88.4, 96/118) in ITT analysis and 85.7% (95% confidence interval: 79.1–92.9 96/112) in PP analysis. Adverse effects associated with eradication therapy were observed in 25 of 118 subjects (21.1%), seven of whom required hospital treatment (rash in five, vomiting in two). All seven subjects either discontinued therapy or were administered anti-allergy drugs, which resulted in swift alleviation of symptoms.
First-line triple therapy with a P-CAB for H. pylori eradication in children was found to be safe.
KeywordsChildren Helicobacter pylori Potassium-competitive acid blocker
The authors acknowledge the considerable support of the public health nurses and all employees of the local governments of Yurihonjo city and Nikaho city, as well as the medical staff and assistants of Yuri Kumiai General Hospital, Akita, Japan.
Guarantor of the article: CK. Conceptualization, data analysis, and manuscript preparation: CK, TG and SS. Data collection: CK, HI, SS. Critical review of the manuscript: TG and MM. All authors have read and approved the submitted version of this manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This project was supported by the anticancer fund of Yurihonjo city and Nikaho city.
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