Clinique pédiatrique Saint-Antoine, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Boulevard de Belfort, 59020 Lille Cedex
Hôpital du Kremlin Bicêtre, AP-HP, Département de microbiologie, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre
Helicobacter pylori (H. pylori) infection in children differs from that in adults in terms of epidemiology, host response, clinical features, diagnosis and treatment strategies. Recurrent abdominal pain is not specific to H. pylori infection in children, and most often the infection is asymptomatic. The initial diagnosis is based on upper gastrointestinal endoscopy with biopsy sampling (culture, PCR, histology). Nodular gastritis is the most common endoscopic finding. H. pylori is a risk factor for duodenal ulcer, but not for gastric ulcer lesions in children in countries with low prevalence of infection. In children, it is recommended that strains be routinely tested for antibiotic susceptibility prior to initiation of antibiotic therapy. Therapeutic management should be based on evaluation of the eradication rate in the local population, systematic use of a treatment adapted to the antibiogram profile, and therapeutic compliance of over 90%. Finally, the latest pediatric guidelines recommend a treatment duration of 14 days for triple therapy.