Resumen

GARCIA, G et al. Erradicación de Helicobacter pylori post-tratamiento en niños con endoscopia control. Gen [online]. 2011, vol.65, n.2, pp.96-100. ISSN 0016-3503.

Introduction: The ideal treatment to eradicate H. pylori in children has not been found. There is little consensus on the indication of reendoscopy and treatment, with concern over bacterial resistance. Objective: To determine the eradication of H. pylori after treatment in patients with an indication of second endoscopy, review of therapeutic and monitoring schemes. Patients and Methods: A prospective study, 73 patients selected from 268 children treated with triple therapy for 14 days. Studied variables: indication of second endoscopy, treatment received, percentage of eradication, failure of treatment and monitoring for two years. Results: Mean age 7.94 years (range: 1-15); 27 (36.98%) males and 46 (63.01%) females. Indication of second endoscopy: abdominal pain (63.01%), severe active chronic gastritis (16.43%), lymphoid clusters (8.21%), focal glandular atrophy (9.58%), intestinal metaplasia (2.73%). Initial treatment indicated: amoxicillin-metronidazole-pump inhibitors 47/73 (63.01%), amoxicillin-clarithromycin-pump inhibitors 18/73 (24.65%), metronidazole-clarithromycin-pump inhibitors 6 / 73 / ( 8.21%) and amoxicillin-Furoxone-pump inhibitors for 2 / 73 (2.73%). Were positive for H. pylori in the second biopsy 31/73 (42.46%). Comparing first and second biopsy, an eradication of 57.53% (p = 0.0001). Efficacy of amoxicillin-clarithromycin-pump inhibitors 77.77%. vs. amoxicillin-metronidazole-pump inhibitors 48.93%, p = 0.0356. Failure to eradicate metronidazole triple therapy 51.06%. There were no significant differences with the other schemes. Upon follow up, a third endoscopy in 10/31 (32.25%), in 8/10 the bacteria were present and 4/8 of them, with fourth endoscopy, 3/4 with persistent infection and one with healing, unable to determine whether it was a recurrence or reinfection. Eradication therapy is complex, it requires improving the therapeutic strategy and monitoring to increase the healing of the infection.

Palabras clave : Helicobacter pylori; Re-endoscopy; Eradication; chronic gastritis; Lymphoid clusters.