Helicobacter pylori infection in childhood: results of management with ranitidine bismuth citrate plus amoxicillin and tinidazole

• Published in: Journal of gastroenterology and hepatology Vol. 15; no. 11; pp. 1243 - 1250
• Main Authors: Nijevitch, A A, Farztdinov, K M, Sataev, V U, Khasanov RSh, Katayev, V A, Khusnutdinov, S M, Akhunov, E D, Kazykhanov, N S
• Format: Journal Article
• Language: English
• Published: Australia 01.11.2000
• Subjects: Adolescent; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - therapeutic use; Bismuth - therapeutic use; Child; Drug Therapy, Combination; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - microbiology; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter pylori - isolation & purification; Humans; Male; Peptic Ulcer - diagnosis; Peptic Ulcer - drug therapy; Peptic Ulcer - microbiology; Ranitidine - analogs & derivatives; Ranitidine - therapeutic use; Tinidazole - therapeutic use
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1046/j.1440-1746.2000.02326.x

To verify whether a triple therapy bismuth citrate plus amoxicillin and tinidazole eradicates H. pylori infection in pediatric patients. Fifty children (30 females; mean age 12.4 +/- 1.1 years, range 10-15 years) suffering from upper abdominal complaints and Helicobacter pylori (H. pylori)-associated gastroduodenal disease were treated with a 4 week course of ranitidine bismuth citrate (400 mg, twice daily) plus oral tinidazole (20 mg/kg) and amoxicillin (50 mg/kg) for the first 2 weeks. The endoscopic diagnoses were: esophagitis (seven cases), gastritis (six cases), gastroduodenitis (43 cases), duodenitis (one case), gastric ulcer (two cases) and duodenal ulcer (13 cases). Helicobacter pylori was eradicated in 40 (80%) patients and clinical improvement was noticed in 39 (78%) of symptomatic subjects. Duodenal ulcers were healed in all the children, but lymphoid nodular hyperplasia was persistent in all patients, independent of the H. pylori status. The potentially drug-related adverse events (blackening of the tongue, six patients; diarrhea, one patient; disturbance of taste, two patients) were registered in seven (14%) patients and dark stools were observed in 48 (96%) patients. No children withdrew from the study because of either side-effects or clinical laboratory changes. No patient had toxic levels of blood bismuth (values ranged between 2.1 and 5.4 microg/L, mean value 3.4 +/- 1.04 microg/L). Findings suggest that the present treatment regimen is effective enough in the resolution of H. pylori-associated peptic ulcer disease of childhood.