Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Treatment of Helicobacter pylori infection in children: A systematic review
Filipe Antônio França da Silva, Breno Bittencourt de Brito, Maria Luísa Cordeiro Santos, Hanna Santos Marques, Mariana Miranda Sampaio, Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Lorena Sousa de Carvalho, Camilo Santana Silva, Luana Kauany de Sá Santos, Márcio Vasconcelos Oliveira, Gifone Aguiar Rocha, Dulciene Maria de Magalhães Queiroz, Fabrício Freire de Melo
Filipe Antônio França da Silva, Breno Bittencourt de Brito, Maria Luísa Cordeiro Santos, Mariana Miranda Sampaio, Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Lorena Sousa de Carvalho, Camilo Santana Silva, Luana Kauany de Sá Santos, Márcio Vasconcelos Oliveira, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Hanna Santos Marques, Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45083-900, Bahia, Brazil
Gifone Aguiar Rocha, Dulciene Maria de Magalhães Queiroz, Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30130-100, Minas Gerais, Brazil
Author contributions: All authors equally contributed to the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and approval of the final version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or coauthors who contributed their efforts in this manuscript.
PRISMA 2009 Checklist statement: A PRISMA checklist was used to guide the development of the systematic review.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, PhD, Postdoctoral Fellow, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremelo@yahoo.com.br
Received: July 29, 2020
Peer-review started: July 29, 2020
First decision: August 22, 2020
Revised: August 28, 2020
Accepted: August 28, 2020
Article in press: August 28, 2020
Published online: August 28, 2020
BACKGROUND
Helicobacter pylori (H. pylori) infection is predominantly acquired in childhood. When indicated, the most accepted treatment for H. pylori eradication in this age group is first-line triple therapy. However, the increasing resistance to clarithromycin and nitroimidazoles has been associated with treatment failure, and thus, alternative treatment regimens have been proposed.
AIM
To perform a systematic review of randomized controlled trials on treatment regimens for H. pylori infection in children.
METHODS
We surveyed relevant articles published in English from 2010 to April 2020 in the PubMed and MEDLINE databases. Keywords included “Helicobacter pylori”/”children or childhood”/”treatment or eradication.” The risk of bias was evaluated according to the Cochrane Handbook of Systematic Reviews for Interventions.
RESULTS
Among the 1144 records identified through the database, 20 articles were selected. Four studies compared the eradication rates of H. pylori infection between standard triple therapies, changing only the main antibiotic used. Seven studies evaluated the effectiveness of standard triple therapy with the addition of probiotics. One study investigated the relationship between the effectiveness in the eradication rates of standard triple therapy and vitamin E levels. Six studies analyzed the eradication rates of sequential therapy.
CONCLUSION
The findings suggest that although standard triple therapy is the most recommended regimen for children by the current guidelines, other therapeutic schemes have shown promising results and may also be recommended for clinical practice in the future.
Core Tip: Helicobacter pylori (H. pylori) is a bacterium that infects more than 50% of the population worldwide. In the last several years, no significant changes in the treatment of infected children have been observed, mainly due to a lack of studies with satisfactory scientific evidence to support the indication of therapies in clinical practice. We performed a systematic review of randomized controlled trials on treatment regimens for H. pylori infection in children.
