Helicobacter pylori infection in children

  • Hien Q. Huynh
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)


Helicobacter pylori is generally acquired in childhood, and the prevalence of this infection varies between and within populations and is decreasing in the developed world. The clinical manifestation of diseases is dependent on the interaction between host, environmental and bacterial factors. The mode of transmission is likely person to person. Strong evidence has accumulated, establishing the causal link between peptic ulcer disease, gastric cancer and mucosal associated lymphoma with H. pylori infection. The association with refractory iron deficiency anemia and idiopathic thrombocytosis purpura are compelling but need more studies. New indications for the eradication of H. pylori are emerging — such as those with strong family history of gastric cancer. Prevention of gastric cancer may require eradication of this bacterium in childhood prior to the development of precancerous lesions. A test-and-treat strategy is not indicated for those with recurrent abdominal pain. In addition, the rate of antibiotic resistance has increased in some populations. Novel eradication strategies need to be developed. Improving the children socioeconomic situation, such as better housing, sanitation and hygiene, remains one of the major pillars in reducing the prevalence of H. pylori children and its diseases burden.


Gastric Cancer Pylorus Infection Triple Therapy Peptic Ulcer Disease Pylorus Eradication 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Parsonnet J (2005) Clinician-discoverers — Marshall, Warren, and H. pylori. N Engl J Med 353: 2421–2423PubMedCrossRefGoogle Scholar
  2. 2.
    Rowland M, Daly L, Vaughan M, Higgins A, Bourke B, Drumm B (2006) Agespecific incidence of Helicobacter pylori. Gastroenterology 130: 65–72PubMedCrossRefGoogle Scholar
  3. 3.
    Ozen A, Ertem D, Pehlivanoglu E (2006) Natural history and symptomatology of Helicobacter pylori in childhood and factors determining the epidemiology of infection. J Pediatr Gastroenterol Nutr 42: 398–404PubMedCrossRefGoogle Scholar
  4. 4.
    Jacobson K (2005) The changing prevalence of Helicobacter pylori infection in Canadian children: should screening be performed in high-risk children? Can J Gastroenterol 19: 412–414PubMedGoogle Scholar
  5. 5.
    Sinha SK, Martin B, Sargent M, McConnell JP, Bernstein CN (2002) Age at acquisition of Helicobacter pylori in a pediatric Canadian First Nations population. Helicobacter 7: 76–85PubMedCrossRefGoogle Scholar
  6. 6.
    O’Rourke K, Goodman KJ, Grazioplene M, Redlinger T, Day RS (2003) Determinants of geographic variation in Helicobacter pylori infection among children on the US-Mexico border. Am J Epidemiol 158: 816–824PubMedCrossRefGoogle Scholar
  7. 7.
    Sood MR, Joshi S, Akobeng AK, Mitchell J, Thomas AG (2005) Growth in children with Helicobacter pylori infection and dyspepsia. Arch Dis Child 90: 1025–1028PubMedCrossRefGoogle Scholar
  8. 8.
    Bures J, Kopacova M, Koupil I, Vorisek V, Rejchrt S, Beranek M, Seifert B, Pozler O, Zivny P, Douda T et al (2006) Epidemiology of Helicobacter pylori infection in the Czech Republic. Helicobacter 11: 56–65PubMedCrossRefGoogle Scholar
  9. 9.
    Axon A (2006) Helicobacter pylori: what do we still need to know? J Clin Gastroenterol 40: 15–19PubMedCrossRefGoogle Scholar
  10. 10.
    Xia HH, Talley NJ (1997) Natural acquisition and spontaneous elimination of Helicobacter pylori infection: clinical implications. Am J Gastroenterol 92: 1780–1787PubMedGoogle Scholar
  11. 11.
    Sgouros SN, Bergele C (2006) Clinical outcome of patients with Helicobacter pylori infection: the bug, the host, or the environment? Postgrad Med J 82: 338–342PubMedCrossRefGoogle Scholar
  12. 12.
    Odenbreit S (2005) Adherence properties of Helicobacter pylori: impact on pathogenesis and adaptation to the host. Int J Med Microbiol 295: 317–324PubMedCrossRefGoogle Scholar
  13. 13.
    Couturier MR, Tasca E, Montecucco C, Stein M (2006) Interaction with CagF is required for translocation of CagA into the host via the Helicobacter pylori type IV secretion system. Infect Immun 74: 273–281PubMedCrossRefGoogle Scholar
  14. 14.
    Bourzac KM, Satkamp LA, Guillemin K (2006) The Helicobacter pylori cag pathogenicity island protein CagN is a bacterial membrane-associated protein that is processed at its C terminus. Infect Immun 74: 2537–2543PubMedCrossRefGoogle Scholar
  15. 15.
    Hatakeyama M, Brzozowski T (2006) Pathogenesis of Helicobacter pylori infection. Helicobacter 11(Suppl 1): 14–20PubMedCrossRefGoogle Scholar
  16. 16.
    Kusters JG, van Vliet AH, Kuipers EJ (2006) Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 19: 449–490PubMedCrossRefGoogle Scholar
  17. 17.
    Rafeey M, Jafari Rouhi AH, Gassemi BA, Rouhi AJ (2004) Relationship between endoscopic nodular gastritis and Helicobacter pylori infection in children. Indian J Gastroenterol 23: 138–139PubMedGoogle Scholar
  18. 18.
    Kato S, Nishino Y, Ozawa K, Konno M, Maisawa S, Toyoda S, Tajiri H, Ida S, Fujisawa T, Iinuma K (2004) The prevalence of Helicobacter pylori in Japanese children with gastritis or peptic ulcer disease. J Gastroenterol 39: 734–738PubMedGoogle Scholar
  19. 19.
    Suerbaum S, Michetti P (2002) Helicobacter pylori infection. N Engl J Med 347: 1175–1186PubMedCrossRefGoogle Scholar
  20. 20.
    Azuma T, Ito S, Sato F, Yamazaki Y, Miyaji H, Ito Y, Suto H, Kuriyama M, Kato T, Kohli Y (1998) The role of the HLA-DQA1 gene in resistance to atrophic gastritis and gastric adenocarcinoma induced by Helicobacter pylori infection. Cancer 82: 1013–1018PubMedCrossRefGoogle Scholar
  21. 21.
    Perri F, Piepoli A, Quitadamo M, Quarticelli M, Merla A, Bisceglia M (2002) HLA-DQA1 and-DQB1 genes and Helicobacter pylori infection in Italian patients with gastric adenocarcinoma. Tissue Antigens 59: 55–57PubMedCrossRefGoogle Scholar
  22. 22.
    El-Omar EM, Carrington M, Chow WH, McColl KE, Bream JH, Young HA, Herrera J, Lissowska J, Yuan CC, Rothman N et al (2000) Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature 404: 398–402PubMedCrossRefGoogle Scholar
  23. 23.
    Leung WK, Chan MC, To KF, Man EP, Ng EK, Chu ES, Lau JY, Lin SR, Sung JJ (2006) H. pylori genotypes and cytokine gene polymorphisms influence the development of gastric intestinal metaplasia in a Chinese population. Am J Gastroenterol 101: 714–720PubMedCrossRefGoogle Scholar
  24. 24.
    Schlemper RJ, van der Werf SD, Biemond I, Lamers CB (1996) Seroepidemiology of gastritis in Japanese and Dutch male employees with and without ulcer disease. Eur J Gastroenterol Hepatol 8: 33–39PubMedCrossRefGoogle Scholar
  25. 25.
    Okuda M, Miyashiro E, Nakazawa T (2004) Helicobacter pylori infection in childhood. J Gastroenterol 39: 809–810PubMedCrossRefGoogle Scholar
  26. 26.
    Ford AC, Delaney BC, Forman D, Moayyedi P (2006) Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. Cochrane Database Syst Rev: CD003840Google Scholar
  27. 27.
    Imrie C, Rowland M, Bourke B, Drumm B (2001) Is Helicobacter pylori infection in childhood a risk factor for gastric cancer? Pediatrics 107: 373–380PubMedCrossRefGoogle Scholar
  28. 28.
    Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, Sasaki N, Schlemper RJ (2001) Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 345: 784–789PubMedCrossRefGoogle Scholar
  29. 29.
    Wong BC, Lam SK, Wong WM, Chen JS, Zheng TT, Feng RE, Lai KC, Hu WH, Yuen ST, Leung SY et al (2004) Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 291: 187–194PubMedCrossRefGoogle Scholar
  30. 30.
    You WC, Brown LM, Zhang L, Li JY, Jin ML, Chang YS, Ma JL, Pan KF, Liu WD, Hu Y et al (2006) Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst 98: 974–983PubMedCrossRefGoogle Scholar
  31. 31.
    Prinz C, Schwendy S, Voland P (2006) H pylori and gastric cancer: shifting the global burden. World J Gastroenterol 12: 5458–5464PubMedGoogle Scholar
  32. 32.
    Bourke B (2005) Will treatment of Helicobacter pylori infection in childhood alter the risk of developing gastric cancer? Can J Gastroenterol 19: 409–411PubMedGoogle Scholar
  33. 33.
    Bourke B, Ceponis P, Chiba N, Czinn S, Ferraro R, Fischbach L, Gold B, Hyunh H, Jacobson K, Jones NL et al (2005) Canadian Helicobacter Study Group Consensus Conference: Update on the approach to Helicobacter pylori infection in children and adolescents — an evidence-based evaluation. Can J Gastroenterol 19: 399–408PubMedGoogle Scholar
  34. 34.
    Malfertheiner P, Fry LC, Monkemuller K (2006) Can gastric cancer be prevented by Helicobacter pylori eradication? Best Pract Res Clin Gastroenterol 20: 709–719PubMedCrossRefGoogle Scholar
  35. 35.
    Macarthur C (2000) Is there an infectious etiology to abdominal pain in children? J Pediatr Gastroenterol Nutr 30: 112PubMedCrossRefGoogle Scholar
  36. 36.
    Malaty HM, Abudayyeh S, Graham DY, Gilger MA, Rabeneck L, O’Malley K (2006) A prospective study for the association of Helicobacter pylori infection to a multidimensional measure for recurrent abdominal pain in children. Helicobacter 11: 250–257PubMedCrossRefGoogle Scholar
  37. 37.
    Yang YJ, Sheu BS, Lee SC, Wu JJ (2005) Short-term recurrent abdominal pain related to Helicobacter pylori infection in children. J Gastroenterol Hepatol 20: 395–400PubMedCrossRefGoogle Scholar
  38. 38.
    Tindberg Y, Nyren O, Blennow M, Granstrom M (2005) Helicobacter pylori infection and abdominal symptoms among Swedish school children. J Pediatr Gastroenterol Nutr 41: 33–38PubMedCrossRefGoogle Scholar
  39. 39.
    Ashorn M, Rago T, Kokkonen J, Ruuska T, Rautelin H, Karikoski R (2004) Symptomatic response to Helicobacter pylori eradication in children with recurrent abdominal pain: double blind randomized placebo-controlled trial. J Clin Gastroenterol 38: 646–650PubMedCrossRefGoogle Scholar
  40. 40.
    Nakayama Y, Horiuchi A, Kumagai T, Kubota S, Taki Y, Oishi S, Malaty HM (2006) Psychiatric, somatic, and gastrointestinal disorders, and Helicobacter pylori infection in children with recurrent abdominal pain. Arch Dis Child 91: 671–674PubMedCrossRefGoogle Scholar
  41. 41.
    Armstrong D, Marshall JK, Chiba N, Enns R, Fallone CA, Fass R, Hollingworth R, Hunt RH, Kahrilas PJ, Mayrand S et al (2005) Canadian Consensus Conference on the management of gastroesophageal reflux disease in adults — update 2004. Can J Gastroenterol 19: 15–35PubMedGoogle Scholar
  42. 42.
    Lundell L, Miettinen P, Myrvold HE, Pedersen SA, Thor K, Andersson A, Hattlebakk J, Havu N, Janatuinen E, Levander K et al (1999) Lack of effect of acid suppression therapy on gastric atrophy. Nordic Gerd Study Group. Gastroenterology 117: 319–326PubMedCrossRefGoogle Scholar
  43. 43.
    Kuipers EJ, Lundell L, Klinkenberg-Knol EC, Havu N, Festen HP, Liedman B, Lamers CB, Jansen JB, Dalenback J, Snel P et al (1996) Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication. N Engl J Med 334: 1018–1022PubMedCrossRefGoogle Scholar
  44. 44.
    Moayyedi P (2005) Should we test for Helicobacter pylori before treating gastroesophageal reflux disease? Can J Gastroenterol 19: 425–427PubMedGoogle Scholar
  45. 45.
    Solnick JV, Franceschi F, Roccarina D, Gasbarrini A (2006) Extragastric manifestations of Helicobacter pylori infection — other Helicobacter species. Helicobacter 11(Suppl 1): 46–51PubMedCrossRefGoogle Scholar
  46. 46.
    Sherman PM, Lin FY (2005) Extradigestive manifestation of Helicobacter pylori infection in children and adolescents. Can J Gastroenterol 19: 421–424PubMedGoogle Scholar
  47. 47.
    Barabino A (2002) Helicobacter pylori-related iron deficiency anemia: a review. Helicobacter 7: 71–75PubMedCrossRefGoogle Scholar
  48. 48.
    Hershko C, Ianculovich M, Souroujon M (2007) A hematologist’s view of unexplained iron deficiency anemia in males: Impact of Helicobacter pylori eradication. Blood Cells Mol Dis 38: 45–53PubMedCrossRefGoogle Scholar
  49. 49.
    Cardenas VM, Mulla ZD, Ortiz M, Graham DY (2006) Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 163: 127–134PubMedCrossRefGoogle Scholar
  50. 50.
    Nahon S, Lahmek P, Massard J, Lesgourgues B, Mariaud de Serre N, Traissac L, Bodiguel V, Adotti F, Delas N (2003) Helicobacter pylori-associated chronic gastritis and unexplained iron deficiency anemia: a reliable association? Helicobacter 8: 573–577PubMedCrossRefGoogle Scholar
  51. 51.
    Baysoy G, Ertem D, Ademoglu E, Kotiloglu E, Keskin S, Pehlivanoglu E (2004) Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 38: 146–151PubMedCrossRefGoogle Scholar
  52. 52.
    Choe YH, Kwon YS, Jung MK, Kang SK, Hwang TS, Hong YC (2001) Helicobacter pylori-associated iron-deficiency anemia in adolescent female athletes. J Pediatr 139: 100–104PubMedCrossRefGoogle Scholar
  53. 53.
    Gessner BD, Baggett HC, Muth PT, Dunaway E, Gold BD, Feng Z, Parkinson AJ (2006) A controlled, household-randomized, open-label trial of the effect that treatment of Helicobacter pylori infection has on iron deficiency in children in rural Alaska. J Infect Dis 193: 537–546PubMedCrossRefGoogle Scholar
  54. 54.
    Akiyama H, Onozawa Y (1998) Effect of omeprazole in chronic idiopathic thrombocytopenic purpura. Am J Hematol 57: 91–92PubMedCrossRefGoogle Scholar
  55. 55.
    Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gasbarrini G (1998) Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori. Lancet 352: 878PubMedCrossRefGoogle Scholar
  56. 56.
    Franchini M, Veneri D (2006) Helicobacter pylori-associated immune thrombocytopenia. Platelets 17: 71–77PubMedCrossRefGoogle Scholar
  57. 57.
    Suzuki T, Matsushima M, Masui A, Watanabe K, Takagi A, Ogawa Y, Shirai T, Mine T (2005) Effect of Helicobacter pylori eradication in patients with chronic idiopathic thrombocytopenic purpura-a randomized controlled trial. Am J Gastroenterol 100: 1265–1270PubMedCrossRefGoogle Scholar
  58. 58.
    Tsutsumi Y, Kanamori H, Yamato H, Ehira N, Kawamura T, Umehara S, Mori A, Obara S, Ogura N, Tanaka J et al (2005) Randomized study of Helicobacter pylori eradication therapy and proton pump inhibitor monotherapy for idiopathic thrombocytopenic purpura. Ann Hematol 84: 807–811PubMedCrossRefGoogle Scholar
  59. 59.
    Jackson S, Beck PL, Pineo GF, Poon MC (2005) Helicobacter pylori eradication: novel therapy for immune thrombocytopenic purpura? A review of the literature. Am J Hematol 78: 142–150PubMedCrossRefGoogle Scholar
  60. 60.
    Jaing TH, Tsay PK, Hung IJ, Chiu CH, Yang CP, Huang IA (2006) The role of Helicobacter pylori infection in children with acute immune thrombocytopenic purpura. Pediatr Blood Cancer 47: 215–217PubMedCrossRefGoogle Scholar
  61. 61.
    Jaing TH, Yang CP, Hung IJ, Chiu CH, Chang KW (2003) Efficacy of Helicobacter pylori eradication on platelet recovery in children with chronic idiopathic thrombocytopenic purpura. Acta Paediatr 92: 1153–1157PubMedCrossRefGoogle Scholar
  62. 62.
    Kurekci AE, Atay AA, Sarici SU, Ozcan O (2004) Complete platelet recovery after treatment of Helicobacter pylori infection in a child with chronic immune thrombocytopenic purpura: a case report. Pediatr Hematol Oncol 21: 593–596PubMedCrossRefGoogle Scholar
  63. 63.
    Takechi T, Unemoto J, Ishihara M, Hosokawa T, Zushi N, Shiraishi T, Ogura H, Wakiguchi H (2006) Idiopathic thrombocytopenic purpura associated with Helicobacter pylori infection. Pediatr Int 48: 76–78PubMedCrossRefGoogle Scholar
  64. 64.
    Hayashi H, Okuda M, Aoyagi N, Yoshiyama M, Miyashiro E, Kounami S, Yoshikawa N (2005) Helicobacter pylori infection in children with chronic idiopathic thrombocytopenic purpura. Pediatr Int 47: 292–295PubMedCrossRefGoogle Scholar
  65. 65.
    Yetgin S, Demir H, Arslan D, Unal S, Kocak N (2005) Autoimmune thrombocytopenic purpura and Helicobacter pylori infection effectivity during childhood. Am J Hematol 78: 318PubMedCrossRefGoogle Scholar
  66. 66.
    Pathak CM, Bhasin DK, Khanduja KL (2004) Urea breath test for Helicobacter pylori detection: present status. Trop Gastroenterol 25: 156–161PubMedGoogle Scholar
  67. 67.
    Niv Y, Abuksis G, Koren R (2003) 13C-urea breath test, referral patterns, and results in children. J Clin Gastroenterol 37: 142–146PubMedCrossRefGoogle Scholar
  68. 68.
    Koletzko S (2005) Noninvasive diagnostic tests for Helicobacter pylori infection in children. Can J Gastroenterol 19: 433–439PubMedGoogle Scholar
  69. 69.
    Frenck RW Jr, Fathy HM, Sherif M, Mohran Z, El Mohammedy H, Francis W, Rockabrand D, Mounir BI, Rozmajzl P, Frierson HF (2006) Sensitivity and specificity of various tests for the diagnosis of Helicobacter pylori in Egyptian children. Pediatrics 118: e1195–1202PubMedCrossRefGoogle Scholar
  70. 70.
    Canete A, Abunaji Y, Alvarez-Calatayud G, DeVicente M, Gonzalez-Holguera JA, Leralta M, Pajares JM, Gisbert JP (2003) Breath test using a single 50-mg dose of 13C-urea to detect Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 36: 105–111PubMedCrossRefGoogle Scholar
  71. 71.
    Dondi E, Rapa A, Boldorini R, Fonio P, Zanetta S, Oderda G (2006) High accuracy of noninvasive tests to diagnose Helicobacter pylori infection in very young children. J Pediatr 149: 817–821PubMedCrossRefGoogle Scholar
  72. 72.
    Gisbert JP, de la Morena F, Abraira V (2006) Accuracy of monoclonal stool antigen test for the diagnosis of H. pylori infection: a systematic review and meta-analysis. Am J Gastroenterol 101: 1921–1930PubMedCrossRefGoogle Scholar
  73. 73.
    Megraud F (2005) Comparison of non-invasive tests to detect Helicobacter pylori infection in children and adolescents: results of a multicenter European study. J Pediatr 146: 198–203PubMedCrossRefGoogle Scholar
  74. 74.
    Bahu Mda G, da Silveira TR, Maguilnick I, Ulbrich-Kulczynski J (2003) Endoscopic nodular gastritis: an endoscopic indicator of high-grade bacterial colonization and severe gastritis in children with Helicobacter pylori. J Pediatr Gastroenterol Nutr 36: 217–222PubMedCrossRefGoogle Scholar
  75. 75.
    Elitsur Y, Lawrence Z, Triest WE (2002) Distribution of Helicobacter pylori organisms in the stomachs of children with H. pylori infection. Hum Pathol 33: 1133–1135PubMedCrossRefGoogle Scholar
  76. 76.
    Van Zanten SJ, Dixon MF, Lee A (1999) The gastric transitional zones: neglected links between gastroduodenal pathology and helicobacter ecology. Gastroenterology 116: 1217–1229PubMedCrossRefGoogle Scholar
  77. 77.
    Logan RP, Walker MM, Misiewicz JJ, Gummett PA, Karim QN, Baron JH (1995) Changes in the intragastric distribution of Helicobacter pylori during treatment with omeprazole. Gut 36: 12–16PubMedGoogle Scholar
  78. 78.
    Rotimi O, Cairns A, Gray S, Moayyedi P, Dixon MF (2000) Histological identification of Helicobacter pylori: comparison of staining methods. J Clin Pathol 53: 756–759PubMedCrossRefGoogle Scholar
  79. 79.
    Chu C, Yu YJ, Kong MS, Ou JT (2003) Rate of Helicobacter pylori infection in children and clonality of Taiwan strains. Microbiol Immunol 47: 813–821PubMedGoogle Scholar
  80. 80.
    Koletzko S, Richy F, Bontems P, Crone J, Kalach N, Monteiro ML, Gottrand F, Celinska-Cedro D, Roma-Giannikou E, Orderda G et al (2006) Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe. Gut 55: 1711–1716PubMedCrossRefGoogle Scholar
  81. 81.
    Huynh HQ (2005) Invasive tests for Helicobacter pylori in children. Can J Gastroenterol 19: 429–432PubMedGoogle Scholar
  82. 82.
    Duck WM, Sobel J, Pruckler JM, Song Q, Swerdlow D, Friedman C, Sulka A, Swaminathan B, Taylor T, Hoekstra M et al (2004) Antimicrobial resistance incidence and risk factors among Helicobacter pylori-infected persons, United States. Emerg Infect Dis 10: 1088–1094PubMedGoogle Scholar
  83. 83.
    Gottrand F, Kalach N, Spyckerelle C, Guimber D, Mougenot JF, Tounian P, Lenaerts C, Roquelaure B, Lachaux A, Morali A et al (2001) Omeprazole combined with Amoxicillin and Clarithromycin in the eradication of Helicobacter pylori in children with gastritis: A prospective randomized double-blind trial. J Pediatr 139: 664–668PubMedCrossRefGoogle Scholar
  84. 84.
    Oderda G, Marinello D, Lerro P, Kuvidi M, de’Angelis GL, Ferzetti A, Cucchiara S, Franco MT, Romano C, Strisciuglio P et al (2004) Dual vs. triple therapy for childhood Helicobacter pylori gastritis: a double-blind randomized multicentre trial. Helicobacter 9: 293–301PubMedCrossRefGoogle Scholar
  85. 85.
    Francavilla R, Lionetti E, Castellaneta SP, Magista AM, Boscarelli G, Piscitelli D, Amoruso A, Di Leo A, Miniello VL, Francavilla A et al (2005) Improved efficacy of 10-day sequential treatment for Helicobacter pylori eradication in children: a randomized trial. Gastroenterology 129: 1414–1419PubMedCrossRefGoogle Scholar
  86. 86.
    Graham DY, Lu H (2006) Is there a role for sequential in sequential anti-H. pylori therapy? Gastroenterology 130: 1930–1931; author reply 1931PubMedCrossRefGoogle Scholar
  87. 87.
    Calvet X, Garcia N, Lopez T, Gisbert JP, Gene E, Roque M (2000) A metaanalysis of short versus long therapy with a proton pump inhibitor, clarithromycin and either metronidazole or amoxycillin for treating Helicobacter pylori infection. Aliment Pharmacol Ther 14: 603–609PubMedCrossRefGoogle Scholar
  88. 88.
    Khurana R, Fischbach L, Chiba N, Veldhuyzen van Zanten S (2005) An update on anti-Helicobacter pylori treatment in children. Can J Gastroenterol 19: 441–445PubMedGoogle Scholar
  89. 89.
    Nijevitch AA, Shcherbakov PL, Sataev VU, Khasanov R, Al Khashash R, Tuygunov MM (2005) Helicobacter pylori eradication in childhood after failure of initial treatment: advantage of quadruple therapy with nifuratel to furazolidone. Aliment Pharmacol Ther 22: 881–887PubMedCrossRefGoogle Scholar

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© Birkhäuser Verlag Basel/Switzerland 2007

Authors and Affiliations

  • Hien Q. Huynh
    • 1
  1. 1.Department of PediatricsStollery Children’s HospitalEdmontonCanada

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