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Métodos Terapêuticos e Terapias MTCI
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J Pediatr Gastroenterol Nutr ; 43(2): 180-4, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16877981

RESUMO

BACKGROUND: Poor compliance to therapy and antibiotic resistance are the main causes for failure of anti-Helicobacter pylori therapy. OBJECTIVE: To evaluate the effectiveness of esomeprazole-based triple therapy directed by susceptibility testing. METHODS: Symptomatic children with H. pylori infection, who underwent successful susceptibility testing and were colonized by no double-resistant strain, received 1-week triple therapy with esomeprazole, amoxicillin and either clarithromycin or metronidazole. Success of eradication was investigated by C-urea breath test. RESULTS: Fifty-eight children (median age, 11.4 years; range, 2.2-17.7 years; 81% immigrants) were included. Helicobacter pylori was resistant to clarithromycin in 5 (9%) and to metronidazole in 9 children (16%). Eradication was successful in 49 (92%) of 53 children receiving esomeprazole, amoxicillin and clarithromycin and in all 5 children treated with metronidazole instead of clarithromycin, resulting in an eradication rate of 93% (95% confidence interval, 83%-98%, intention-to-treat analysis). All 4 treatment failures occurred in immigrants with language problems; 2 of them were obviously noncompliant. CONCLUSION: Esomeprazole-based 1-week triple therapy directed by susceptibility testing is highly effective for eradication of H. pylori infection in children.


Assuntos
Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Esomeprazol/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Adolescente , Amoxicilina/uso terapêutico , Testes Respiratórios , Criança , Pré-Escolar , Claritromicina/uso terapêutico , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Quimioterapia Combinada , Feminino , Helicobacter pylori/efeitos dos fármacos , Humanos , Masculino , Metronidazol/uso terapêutico , Testes de Sensibilidade Microbiana , Cooperação do Paciente , Estudos Prospectivos , Resultado do Tratamento
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