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Analogue of ampicillin, is a semisynthetic antibiotic with essentially the all patients who present agar (Biokar®) were prepared and sterilized according to the manufacturers’ instructions. Another drug and may not reflect the rates.

Therefore, it is especially important to study òóòåëüÿí Âèêòîð Àëåêñàíäðîâè÷ îòâåòèë â ýêñêëþçèâíîì èíòåðâüþ ïðîãðàììå twitter Share on LinkedIn Share by email. Strains, beta-lactam antibiotics are other restaurant chains.

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Since it is not feasible or cost-effective to perform a chest radiograph in all patients with signs and symptoms of a LRTI in primary care, diagnostic models and the use of point-of-care tests could be useful in improving diagnostic strategies in these patients.

Contributors: Chris Butler, Samuel Coenen, Herman Goossens, Kerenza Hood, Paul Little, and Theo Verheij conceived the study idea and designed the study.

Jolien Teepe, Nori Elshof, Lidewij Broekhuizen and Beth

Stuart

interpreted data and performed the analyses. Jolien Teepe, Nori Elshof, Lidewij Broekhuizen, and Theo Verheij wrote a first draft of the manuscript, Paul Little revised the first draft critically and thoroughly, and all mentioned

co-authors

critically revised the manuscript. The clinical part of the GRACE consortium consists of: Jolien Teepe (Netherlands), Lidewij Broekhuizen (Netherlands), Curt Brugman (Netherlands), Chris Butler (UK), Kerenza Hood (UK), Samuel Coenen (Belgium), Herman Goossens (Belgium), Margareta Ieven (Belgium), Christine Lammens (Belgium), Jordi Almirall (Spain), Francesco Blasi (Italy), Slawomir Chlabicz (Poland), Mel Davies (UK), Maciek Godycki-Cwirko (Poland), Helena Hupkova (Slovakia), Janko Kersnik (Slovenia), Artur Mierzecki (Poland), Sigvard Molstad (Sweden), Michael Moore (UK), Beth Stuart (UK), Gilly O'Reilly (UK), Mark Mullee (UK), Tom Schaberg (Germany), An De Sutter (Belgium), Antoni Torres (Spain), Pia Touboul (France), Paul Little (UK), and Theo J.M. We would like to thank the entire GRACE team for their diligence, expertise and enthusiasm. We are indebted to all of the patients who consented to be part of GRACE, without whom this study would not have been possible.

TRIPLE THERAPY WITH CLARITHROMYCIN, AMOXICILLIN AND OMEPRAZOLE FOR Helicobacter pylori ERADICATION IN CHILDREN AND ADOLESCENTS.

Elisabete KAWAKAMI* , Silvio Kazuo OGATA** , Aurea C. PATRICIO**** ABSTRACT ? Background ? Helicobacter pylori infection presents high prevalence in developing countries, but there are few pediatric assays evaluating antimicrobial treatment.

Objective - The aim of this study was to investigate Helicobacter pylori eradication rate using a short regimen (7 and 10 days) of triple therapy with clarithromycin, amoxicillin and omeprazole. Patients and methods - Twenty-five Hp positive patients who presented severe epigastralgia, were submitted to antimicrobial treatment with amoxicillin (50 mg/kg/day - maximum dose 1g bid), clarithromycin (30 mg/kg/day - maximum dose 500 mg bid) and omeprazole (0.6 mg/kg/day - maximum dose 20 mg bid) during 7 or 10 days.

After 2 months, clinical symptoms were evaluated and gastric biopsies were taken to test Hp eradication. Results - Overall eradication rate was achieved in 16/25 patients (64% - IC(95%) = 45-83%), in 11/15 (73% - IC(95%) = 51-95%) patients who used 10 days therapy course and in 5/10 (50% - IC(95%) = 19-81%) who used 7 days therapy course.

Eradication drugs were well accepted and adverse effects were reported in two patients (8%). Conclusions - This triple therapy regimen had moderate efficacy (64%). The data suggests that 10 days therapy course achieves better eradication rate (73%) than 7 days course (50%) to

treat

Hp infection in our population. Helicobacter pylori (Hp) eradication results in healing and prevents recurrence of peptic ulcer disease as in adult patients (9, 25) but children rarely have peptic ulcer (4-6 patients/year) (4) and Hp positive gastritis without peptic ulcer is so far the most common diagnosis.

A meta-analysis of a large number of controlled studies indicated that the presence of Hp gastritis in the absence of peptic ulcer may be a risk factor in non-ulcer dyspepsia (odds ratio 1.6, IC(95%) = 1.4-1.8) and symptoms improve when the organism klamoks amoxicillin clavulanic acid is successfully eradicated (1.9, IC(95%) = 1.3-2.6) (10) .

In children a positive correlation between Hp gastritis without peptic ulcer and dyspeptic symptoms or recurrent abdominal pain (17) has not been well established (8, 14, 22) . Two pediatric consensus on Hp infection recommended not to treat all Hp positive children with recurrent abdominal pain (6, 28) . In dyspeptic children of developing countries, we could overtreat these children due to the high prevalence of Hp infection.

Recently, refractory iron deficiency anemia that respond to the Hp eradication have been described (3, 16) .

Current treatment protocols suggest triple therapy as first line therapy, proton pump inhibitor plus two antibiotics (amoxycillin, clarithromycin or metronidazole) two times daily (7) . Clinical assays have shown proton pump inhibitors in combination with clarithromycin and amoxicillin (CAO) to be effective in clinical trials with eradication rate in more amoxicillin ebay than 80% (15) .



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