Médecine thérapeutique / Pédiatrie
MENUHelicobacter pylori infection in children Volume 21, issue 2, Avril-Mai-Juin 2018
- Key words: Helicobacter pylori, epidemiology, diagnosis, treatment, child
- DOI : 10.1684/mtp.2018.0677
- Page(s) : 57-65
- Published in: 2018
Helicobacter pylori (H. pylori) infection in children differs from that in adults for epidemiology, host response, clinical features, diagnosis, as well as treatment strategies.
The prevalence of H. pylori infection, in both children and adults, is decreasing in the western world as well as in some developing countries. Recurrent abdominal pain is not specific during H. pylori infection in children and the infection is usually asymptomatic.
The main initial diagnosis is based on upper digestive endoscopy with biopsy-based methods. Nodular gastritis is the most frequent endoscopic finding of childhood H. pylori infection. H. pylori remain a risk factor for duodenal ulcer, but not for gastric ulcer lesions in children in countries with low prevalence of infection. The infection eradication control is based on validated non-invasive tests.
Standard antibiotic susceptibility testing of H. pylori is recommended in pediatric patients prior to the initiation of antibiotic therapy. H. pylori treatment in children should be focused on: The systematic use of a treatment adapted to susceptibility profile and a treatment compliance greater than 90%. Finally, the last pediatric guidelines recommend the use of 14-days triple therapy.
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