To compare clinical and endoscopic features of H. pylori infected and non-infected children, and evaluate antimicrobial resistance and eradication rates between tailored and empirical treatments.
Approach:
Study Design: Retrospective analysis of children diagnosed with H. pylori via gastroscopy and histology over 3 years, matched with H. pylori-negative controls.
Treatment Comparison: Infected children with known antibiotic susceptibility received tailored therapy, while others were treated empirically.
Key Findings:
No significant differences in clinical and endoscopic features between infected and non-infected children.
Chronic active gastritis was present in all infected children, while non-active gastritis was found in non-infected children.
Resistance rates were 46.2% for clarithromycin and 23.1% for metronidazole.
Eradication rates were 100% for tailored therapy versus 75% for empirical therapy.
Interpretation:
Infected and non-infected children exhibit similar clinical and endoscopic features, indicating that diagnosis cannot rely solely on these characteristics. Tailored therapy is more effective than empirical treatment when resistance testing is available.
Limitations:
Small sample sizes limit the ability to draw broad conclusions.
Conclusion:
Tailored therapy for H. pylori infection in children shows maximum efficacy, and empirical regimens should be avoided when resistance testing is available.
