Expertos Invitados





TRATAMENTO DA INFECÇAO POR HELICOBACTER PYLORI EM CRIANÇAS E ADOLESCENTES

(especial para SIIC © Derechos reservados)
kawakami.jpg Autor:
Elisabete Kawakami
Columnista Experto de SIIC
Artículos publicados por Elisabete Kawakami
Coautor
Silvio Kazuo Ogata -* 
Mestre e Pós-graduando da Disciplina de Gastroenterologia Pediátrica da Universidade Federal de São Paulo - Escola Paulista de Medicina.*
Recepción del artículo
21 de Abril, 2003 		Primera edición
23 de Julio, 2003 		Segunda edición, ampliada y corregida
7 de Junio, 2021

TRATAMENTO DA INFECÇAO POR HELICOBACTER PYLORI EM CRIANÇAS E ADOLESCENTES

Resumen
Existem poucos ensaios terapêuticos para avaliação da eficácia do tratamento de erradicação do H.pylori em crianças, ao contrário do relatado na literatura médica em pacientes adultos. A grande maioria é de estudos abertos, não randomizados, não havendo nenhum placebo controlado. Além disto, não há critérios mínimos para determinar a eficácia, assim como critérios homogêneos na seleção de pacientes. O tratamento medicamentoso deve ser sempre testado em cada região, dado a diversidade na aderência, cepas diferentes e resposta do hospedeiro. Em criança, geralmente o esquema terapêutico a ser testado baseia-se em tratamentos já testados em pacientes adultos, dada a menor indicação de tratamento, devido á baixa prevalência de úlcera péptica, que constitui a principal indicação de tratamento em pacientes adultos. O tratamento inicial mais recomendado consiste de esquema tríplice com inibidor da bomba de prótons associado a dois antimicrobianos: claritromicina, amoxicilina ou metronidazol em duas tomadas diárias por 1 ou 2 semanas. Estudo duplo-cego com terapia tríplice contendo amoxicilina, claritromicina e omeprazol por uma semana, comparado com terapia dupla com claritromicina e amoxicilina apresentou erradicação em 75% e 9,4% respectivamente. Estudo aberto em nosso serviço com o mesmo esquema tríplice, apresentou eficácia menor (50% e 73%) utilizando o mesmo esquema durante 7 e 10 dias. Avaliação de novo esquema tríplice (claritromicina, furazolidona e inibidor da bomba de prótons - 7 dias) tem mostrado melhor índice de erradicação, dado já comprovado em pacientes adultos de nosso país. A falha no tratamento tem sido associado a fatores como aderência ao tratamento ou as características próprias do H.pylori como resistência bacteriana aos antimicrobianos e a capacidade do H.pylori em se aderir ao epitélio gástrico, abaixo da camada de muco, dificultando o acesso das drogas antimicrobianas. Acredita-se que os marcadores de virulência também influenciem na eficácia da erradicação. Quando não há resposta ao tratamento inicial, recomenda-se o esquema quádruplo baseado em drogas não prescritas anteriormente, devido á resistência antimicrobiana secundária; mas o ideal seria um esquema antimicrobiano baseado no estudo de resistência bacteriana através de cultura da bactéria e antibiograma.

Palabras clave
Helicobacter pylori, crianças, adolescentes, erradicação


Artículo completo
(castellano)
Extensión:  +/-9.73 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
There are few available data about evaluation of eradication treatment efficacy in children, frequently with open, no randomized and no controlled studies. There are no minimum criteria to determine efficacy or selection of patients for the studies. The recommended first line treatment consists of proton pump inhibitor plus two antibiotics clarithromycin, amoxicillin, or metronidazole, twice a day, during 1 or 2 weeks. Double blind assay using triple therapy - clarithromycin, amoxicillin and omeprazole during 1 week, compared with double therapy using clarithromycin and amoxicillin presents eradication rate in 75% and 9,4% respectively. In our country, open assay using the same schedule presents lower efficacy (50% and 73%) during 7 and 10 days. A new triple therapy for H.pylori eradication has been evaluated (clarithromycin, furazolidone and proton pump inhibitor - 7 days) showing better eradication rate, that was demonstrated by adult assay in our country. Treatment failure has been associated with no compliance to treatment or due to H. pylori characteristics, like antimicrobials resistance and H.pylori capacity to adhere to gastric epithelium above mucus, decreasing antimicrobials drugs access. Maybe virulence markers also influence eradication efficacy. When first line treatment fails, quadruple regimen is recommended, based on previous not used drugs, but because secondary antimicrobial resistance, the best way would be an antimicrobial schedule based on culture and antibiogram.

Key words
Helicobacter pylori, crianças, adolescentes, erradicação

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Pediatría
Relacionadas: Epidemiología, Gastroenterología, Infectología, Medicina Familiar, Medicina Interna



Comprar este artículo
Extensión: 9.73 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Bibliografía del artículo
  1. Xia HHX, Talley NJ. Natural acquisition and spontaneous elimination of Helicobacter pylori infection: Clinical Implications. Am J Gastroenterol 1997; 92:1780-87.
  2. Miyazaki M, Kato M, Takata T, Une H. Intrafamilial transmission of Helicobacter pylori: the association between a parent and an offspring with respect to the presence of anti-CagA antibody. J Infect Dis 2002;8:70-5.
  3. Malaty H, Logan N, Graham D et al. Helicobacter pylori infection in preschool and school-aged minority children. Effect of socioeconomic indicators and breast feeding practices. Clin Infect Dis 2001; 32:1387-92.
  4. Staat MA; Kruszon-Moran D; Mcquillan GM et al. A population-based serologic survey of Helicobacter pylori infection in children and adolescents in the United States. J Infect Dis 1996; 174:1120-3.
  5. Ernst PB, Gold BD. Helicobacter pylori in childhood: new insights into the immunopathogenesis of gastric disease and implications for managing infection in children. J Pediatr Gastroenterol Nutr 1999; 28:462-73.
  6. Lindkvist P, Asrat D, Nilsson I et al. Age at acquisition of Helicobacter pylori infection: Comparison of a high and a low prevalence country. Scand J Infect Dis 1996; 28:181-4.
  7. Holcombe C, Tsimiri S, Eldridge J, Jones DM. Prevalence of antibody to Helicobacter pylori in children in northern Nigeria. Trans R Soc Trop Med Hyg, 1993; 87:19-21.
  8. Hopkins RJ, Vial PA, Ferreccio C et al. Seroprevalence of Helicobacter pylori in Chile: Vegetables may serve as one route of transmission. J Infect Dis 1993; 168:222-6.
  9. Oliveira AMR, Queiroz DMM, Rocha GA, Mendes EN - Seroprevalence of Helicobacter pylori infection in children of low socio-economic level in Belo Horizonte, Brazil. Am J Gastroenterol 1994; 89:2201-4.
  10. Olmos JA, Higa R, Rios H et al. Association between subjects with dyspeptic symptoms and Helicobacter pylori infection: Epidemiologic study conducted at 16 centers in Argentina. Gastroenterolgy 1998; 114: A:1016.
  11. Klein PD, Gilman RH, Leon-Barua R et al. The epidemiology of Helicobacter pylori in Peruvian children between 6 and 30 months of age. Am J Gastroenterol 1994; 12:2196-200.
  12. Dehesa M, Robles-Diaz G, Garcia M et al. Seroepidemiology of Helicobacter pylori in Mexico. Gastroenterology 1993; 104(suppl 2):A65.
  13. Portorreal ACM, Kawakami E. Soroprevalência da infecção por Helicobacter pylori (H.pylori) em crianças de baixo nível socioeconômico na cidade de São Paulo, Brasil. In: X Congresso Brasileiro de Gastroenterologia Pediátrica, Brasília, 2001. Abstract book.
  14. Oliveira AMR, Rocha GA, Queiroz DMM et al. Evaluation of enzyme-linked immunosorbent assay for the diagnosis of Helicobacter pylori infection in 157 children from different age groups with and without duodenal ulcer. J Pediatr Gastroenterol Nutr 1999; 28:157-61.
  15. Souto FJ, Fontes CT, Rocha GA et al. Prevalence of Helicobacter pylori infection in a rural area of the state of Mato Grosso, Brazil. Mem Inst Oswaldo Cruz 1998; 97:171-4.
  16. Mitchell HM; Li YY; Ho PJ. Epidemiology of Helicobacter pylori in Southern China: Identification of early childhood as the critical period of acquisition. J Infect Dis 1992; 166:149-53.
  17. Parsonnet J. The incidente of Helicobacter pylori infection. Aliment Pharmacol Ther 1995; 9:45-51.
  18. Malaty HM; Graham DY; Wattigney WA et al. Natural history of Helicobacter pylori infection in childhood: 12 years follow-up cohort study in a bi-racial community. Clin Infect Dis 1999; 28:279-82.
  19. Blaser MJ; Chyou PH; Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res 1995; 5:562-5.
  20. Nomura A, Stemmermann GN, Chyou PH et al. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med 1991; 325:1132-6.
  21. Parsonnet J, Friedman GD, Vandersteen DP et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med 1991; 325:1127-31.
  22. Forman D, Newell DG, Vandersteen DP et al. Association between infection with Helicobacter pylor and risk of gastric cancer: evidence from a prospective investigation. BMJ 1991; 302:1302-5.
  23. International Agency for research on Cancer. Anonymous live flukes and Helicobacter pylor. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, France: IARC Monogr Eval Carcinog Risks Hum 1994; 61:1-241.
  24. Holcombe C. H pylor: The African enigma. Gut 1992; 33:429-31.
  25. WatanabeT, Tada M, Nagai H et al. Helicobacter pylor infection induces gastric cancer in Mongolian gerbils. Gastroenterology 1998; 115:642-8.
  26. Honda S, Fujioka T, Tokieda M et al. Development of Helicobacter pylori-induced gastric carcinoma in mongolian gerbils. Cancer Res 1998; 58:4255-9.
  27. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process - First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992; 52:6735-40.
  28. Villako K, Kekki M, Maaroos HI et al. Chronic gastritis: progression of inflammation and atrophy in a six-year endoscopic follow-up of a random sample of 142 Estonian urban subjects. Scand J Gastroenterol Suppl 1991; 186:135-41.
  29. Hansson LE, Nyren O, Hsing AW et al. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N Engl J Med 1996; 335:242-9., 1996
  30. Uemura N, Okamoto S, Yamamoto S et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345:784-9.
  31. Dunn BE, Cohen H, Blaser MJ. Helicobacter pylori. Clin Microbiol Rev 1997; 10:720-41.
  32. Censini S, Lang C, Xiang Z et al. Cag, a pathogenicity island of Helicobacter pylori, encodes type I-specific and disease-associated virulence factors. Proc Natl Acad Sci USA 1996; 93:14648-53.
  33. Covacci A, Falkow S, Berg DE, Rappuoli R. Did the inheritance of a pathogenicity island modify the virulence of Helicobacter pylori Trends Microbiol 1997; 5:205-8.
  34. Covacci A, Censini S, Bugnoli M et al. Molecular characterization of the 128kDa immunodominant antigen of Helicobacter pylori associated with cytotoxicity and duodenal ulcer. Proc Natl Acad Sci USA 1993; 90:5791-5.
  35. Evans DG, Queiroz DMM, Mendes EM, Evans Jr DJ. Helicobacter pylori cagA status and s and m alleles of vacA in isolates from individuals with a variety of H.pylori-associated gastric diseases. J Clin Microbiol 1998; 36:3435-7.
  36. Queiroz DMM, Rocha GA, Mendes EM et al. Differences in distribution and severity of Helicobacter pylori gastritis in children and adults with duodenal ulcer disease. J Pediatr Gastroenterol Nutr 1991; 12:178-81.
  37. Queiroz DM; Mendes EN; Carvalho AS et al. Factors associated with Helicobacter pylori infection by a cagA-positive strain in children. J Infect Dis 2000; 181:626-30.
  38. Oderda G, Figura N, Bayeli PF et al. Serologic IgG recognition of Helicobacter pylori cytotoxin-associated protein, peptic ulcer and gastroduodenal pathology in childhood. Eur J Gastroenterol Hepatol 1993; 5:695-9.
  39. Husson M-O, Gottrand F, Vachee A et al. Importance in diagnosis of gastritis of detection by PCR of the cagA gene in Helicobacter pylori strains isolated from children. J Clin Microbiol 1995; 33:3300-3.
  40. Mitchell HM, Hazell SL, Bohane TD et al. The prevalence of antibody to CagA in children is not a marker for specific disease. J Pediatr Gastroenterol Nutr 1999; 28:71-5.
  41. Loeb M, Jayaratne P, Jones N et al. Lack of correlation between vacuolating cytotoxin activity, cagA gene in Helicobacter pylori and peptic ulcer disease in children. Eur J Clin Microbiol Infect Dis 1998; 17:653-6.
  42. Miehlke S, Kibler K, Kim JG et al. Allelic variation in the cagA gene of Helicobacter pylori obtained from Korea compared to the United States. Am J Gastroenterol 1996; 91:1322-5.
  43. Pan ZJ, Van der Hulst RW, Feller M et al. Equally high prevalences of infection with cagA-positive Helicobacter pylori in Chinese patients with peptic ulcer disease and those with chronic gastritis-associated dyspepsia. J Clin Microbiol 1997; 35:1344-7.
  44. Haenszel W, Kurihara M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst 1968; 40:43-68.
  45. Howson CP, Hiyama T, Wynder EL. The decline in gastric cancer: Epidemiology of an unplanned triumph. Epidemiol Rev 1986; 8:1-27.
  46. El Omar EM, Carrington M, Chow WH et al. Interleukin-1 association with increased risk of gastric cancer. Nature 2000; 404:398-402.
  47. Ramon JM, Serra L, Cerco C et al. Dietary factors and gastric cancer risk. A case-control study in Spain. Cancer 1993; 71:1731-5.
  48. Neuget AI, Hayek M, Howe G. Epidemiology of gastric cancer. Semin Oncol 1996; 23:281-91.
  49. Weisburger JH, Marquardt H, Mower HF et al. Inhibition of carcinogenesis: vitamin C and the prevention of gastric cancer. Prev Med 1980; 9:352-61.
  50. Crabtree JE, Covacci A, Farmery SM et al. Helicobacter pylori induced interleukin-8 expression in gastric epithelial cells is associated with cagA-positive phenotype. J Clin Pathol 1995, 48:41-5.
  51. Parsonet J, Friedman GD, Orentreich N, Vovelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 1997; 40:297-301.
  52. Rudi J, Kolb C, Maiwald M et al. Serum antibodies against Helicobacter pylori proteins VacA and CagA are associated with increased risk of gastric adenocarcinoma. Dig Dis Sci 1997; 42:1652-9.
  53. Mitchell HM, Hazell SL, Hu PJ et al. Serological response to specific Helicobacter pylori antigens: antibody against CagA antigen is not predictive of gastric cancer in a developing country. Am J Gastroenterol 1996; 91:1785-8.
  54. Pérez-Pérez GI, Bhat N, Gaensbauer J et al. Country-specific constancy by age in cagA+ proportion of Helicobacter pylori infections. Int J Cancer 1997, 72:453-6.
  55. Shimoyama T, Fukuda S, Tanaka M et al. High prevalence of the CagA-positive Helicobacter pylori strains in Japanese asymptomatic patients and gastric cancer patients. Scand J Gastroenterol 1997: 32:465-8.
  56. Azuma T, Ito S, Sato Fet al. The role of the HLA-DQA1 gene in resistance to atrophic gastritis and gastric adenocarcinoma induced by Helicobacter pylori infection. Cancer 1998; 82:1013-8.
  57. Yu J, Ebert MP, Miehlke S et al. Alpha-catennin expression is decreased in human gastric cancers and in the gastric mucosa of first degree relatives. Gut 2000; 46:639-44.
  58. Ebert MO, Yu J, Miehlke S et al. Expression of transforming growth factor beta-1 in gastric cancer and in the gastric mucosa of first-degree relatives of patients with gastric cancer. Br J Cancer 2000; 82:1795-800.
  59. Kato S, Onda M, Yamada S et al. Association of the interleukin-1 beta genetic polymorphism and gastric cancer risk in Japanese. J Gastroenterol 2001; 36:696-9.
  60. Imrie C; Rowland M; Bourke B; Drumm B. Is Helicobacter pylori infection in childhood a risk factor for gastric cancer Pediatrics 2001; 107:373-80.
  61. Parsonnet J; Harris RA; Hack HM; Owens DK. Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer: a mandate for clinical trials. Lancet 1996; 348:150-4.
  62. Leung WK, Sung JJ. Review article: intestinal metaplasia and gastric carcinogenesis. Aliment Pharmacol Ther 2002;16:1209-16.
  63. Gail MH, You WC, Chang YS et al. Factorial trial of three interventions to reduce the progression of precancerous gastric lesions in Shandong, China: design issues and initial data. Controlled Clin Trials 1998; 19:352-69.
  64. Lambert R. Mass screening programs in Japan: what can we learn in the West Endoscopy 1998; 30:721-3.
  65. Lorens P. Gastric cancer mass survey in Chile. Sem Surg Oncol 1991; 7:339-43.
  66. Pisani P, Oliver WE, Parkin DM et al. Case-control study of gastric cancer screening in Venezuela. Br J Cancer 1994; 69:1102-5.
  67. Chiba N, Thomson AB, Sinclair P. From bench to bedside to bug: an update of clinically relevant advances in the care of persons with Helicobacter pylori-associated diseases. Can J Gastroenterol 2000; 14:188-98.
  68. Deckelbaum BJ, Roy CC, Lussier-Lazaroff J et al. Peptic ulcer disease: a Clinical study in 73 children. Can Med Assoc J 1974; 111: 225.
  69. Drumm B, Rhoads JM, Stringer DA et al. Peptic ulcer disease in children: etiology, clinical findings and clinical course. Pediatrics 1988; 82: 410.
  70. Murphy MS, Eastham EJ, Jimenez M et al. Duodenal ulceration: Review of 110 cases. Arch Dis Child 1987; 62: 544.
  71. Puri P, Boyd E, Blake N, Guiney EJ. Duodenal ulcer in childhood: a continuing disease in adult life. J Pediatr Surg 1978; 13: 525.
  72. Hassall E & Dimmick JE. Unique features of Helicobacter pylori disease in children. Dig Dis Sci 1991; 36:417.
  73. Yeung CK, Fu KH, Yuen KY et al. Helicobacter pylori and associated duodenal ulcer. Arch Dis Child 1990; 65:1212.
  74. Dohil R; Hassal E; Jevon G et al. Gastritis and Gastropathy of Childhood. J Pediatr Gastroenterol Nutr 1999; 29:378-94.
  75. Sainz R, Borda F, Dominguez E, Gisbert JP Y Grupo Conferencia Española de Consenso. Conferencia Española de Consenso sobre la infección por Helicobacter pylori. Rev Esp Enferm Dig 1999; 91:777-784.
  76. Macarthur C. Helicobacter pylori infection and childhood recurrent abdominal pain: lack of evidence for a cause-end-effect relationship. Can J Gastroenterol 1999; 13:607-10.
  77. Drumm B, Koletzko S, Oderda G. Helicobacter pylori infection in children: a consensus statement. J Pediatr Gastroenterol Nutr 2000; 30:207-13.
  78. Gold BD, Colletti RB, Abbott M et al. Helicobacter pylori infection in children: recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr 2000; 31:490-7.
  79. Sherman P, Hassal E, Hunt RH et al. Canadian Helicobacter Study Group Consensus Conference on the approach to Helicobacter pylori infection in children and adolescents. Can J Gastroenterol 1999; 13:553-9.
  80. Blum AL, Talley NJ, O\'Morain C et al. Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia: omeprazole plus clarithroycin and amoxicillin effect one year after treatment (OCAY) study group. N England J Med 1998; 339:1875-81.
  81. McColl K, Murray L, El-Omar E et al. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med 1998; 339:1869-74.
  82. Talley NJ, Janssens J, Lauritsen K et al. Eradication of Helicobacter pylori in functional dyspepsia: randomized double blind placebo controlled trial with 12 months follow up. The Optimal Regimen Cures Helicobacter Induced Dyspepsia (ORCHID) study group. BMJ 1999; 318:833-7.
  83. Moayyedi P, Soo S, Deeks J et al. Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. BMJ 2000, 321:659-64.
  84. Fuchs CS & Mayer RJ. Gastric carcinoma. N Engl J Med 1995; 333:32-41.
  85. Buckley M & O\'Morain CA. Prevalence of Helicobacter pylori in nonulcer dyspepsia. Aliment Pharmacol Ther 1995; 9:53-8.
  86. Loffeld RJLF, Stobberingh E, Flendrig JA et al. Presence of Helicobacter pylori in patients with non-ulcer dyspepsia revealing normal antral histological characteristics. Digestion 1990, 47:29-34.
  87. Kalach N, Raymond J, Benhamou PH et al. Managing intrafamilial dissemination of Helicobacter pylori gastric infection improves eradication rates in children (Letter). J Pediatr Gastroenterol Nutr 1999; 28:356.
  88. Oderda G, Ponzetto A, Boero M et al. Family treatment of symptomatic children with Helicobacter pylori infection. Ital J Gastroenterol Hepatol 1997; 29:509-14.
  89. Barabino A, Dufour C, Marino CE et al. Unexplained refractory iron-deficiency anemia associated with Helicobacter pylori gastric infection in children: Further clinical evidence. J Pediatr Gastroenterol Nutr 1999; 28:116-9.
  90. Marignani M, Angeletti S, Bordi C et al. Reversal of long-standing iron deficiency anemia after eradication of Helicobacter pylori infection. Scand J Gastroenterol 1997; 32:617-22.
  91. Dixon MF, Genta RM, Yardley JH . Classification and grading of gastritis: the update Sydney system. Am J Surg Pathol 1994; 20:1161-81.
  92. Peura D. Helicobacter pylori: rational management options. Am J Med 1998; 105:424-30.
  93. Huang JQ & Hunt RH - The importance of clarithromycin dose in the management of Helicobacter pylori infection: a meta-analysis of triple therapies with a proton pump inhibitor, clarithromycin and amoxycillin or metronidazole. Aliment Pharmacol Ther 1999; 13:719-29.
  94. Harris A. Current regimens for treatment of Helicobacter pylori infection. Br Med Bull 1998; 54:195-205.
  95. Uc A, Chong SKF. Treatment of Helicobacter pylori gastritis improves dyspeptic symptoms in children. J Pediatr Gastroenterol Nutr 2002; 34:281-5.
  96. Oderda G, Rapa A, Bona G. A systematic review of Helicobacter pylori eradication treatment schedules n children. Aliment Pharmacol Ther 2000; 14(Suppl)59-66.Oderda G, Cadranel S, Drumm B, Koletzki S. Announcing the creation of the pediatric European register for treatment of Helicobacter pylori (PERTH). J Ped Gastroenterol Nutr 2001; 33:526-7.
  97. Rowland M, Imrie C, Bourke B, Drumm B. How should Helicobacter pylori infected children be managed Gut 1999; 45:1336-9.
  98. The European Helicobacter pylori Study Group. Current European concepts in the management of Helicobacter pylori infection. The Maastrich Consensus Report. Gut 1997; 41:8-13.
  99. Gottrand F, Kalach N, Spyckerelle C et al. Omeprazole combined with amoxicillin and clarithromycin in the eradication of Helicobacter pylori in children with gastritis: a prospective randomizaed double-blind trial. J Pediatr 2001; 139:664-8.
  100. Kawakami E, Ogata SK, Portorreal ACM et al. Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents. Arq Gastroenterol 2001; 38:203-6.
  101. Kawakami E, Machado RS, Scuissiato ML et al. Esquema tríplice com Furazolidona, Omeprazol e Claritromicina para erradicação de Helicobacter pylori (H. pylori) em crianças e adolescentes. In: V Semana Brasileira do Aparelho Digestivo, Rio de Janeiro, 2002. Abstract book.
  102. Dani R, Queiroz DMM, Dias MGM et al. Omeprazole, clarithromycin and furazolidone for the eradication of Helicobacter pylori in patients with duodenal ulcer. Aliment Pharmacol Ther 1999, 13:1647-52.
  103. Tirén U, Sandstedt B, Finkel Y. Helicobacter pylori gastritis in children: efficacy of 2 weeks of treatment with clarithromycin, amoxicillin and omeprazole. Acta Pediatr 1999; 88:166-8.
  104. Behrens R, Lang T, Keller KM. Dual versus triple therapy of Helicobacter pylori infection: results of a multicentre trial. Arch Dis Child 1999, 81:68-70.
  105. Van der Hulst RW, Weel JF, Verheul SB et al. Treatment of Helicobacter pylori infection with low and high dose omeprazole combined with amoxicillin and the effect of early retreatment: a prospective randomised double-blind study. Aliment Pharmacol Ther 1996; 10:165-71.
  106. Unge P. What other regimens are under investigation to treat Helicobacter pylori infection Gastroenterology 1997; 113(Suppl6):S131-48.
  107. Lind T; Mégraud F; Unge P et al. The MACH2 study: role of omeprazole in eradication of Helicobacter pylori with 1-week triple therapies. Gastroenterology 1999; 116:248-53.
  108. Peitz U, Hackelsberger A, Malfertheiner P. A pratical approach to patients with refractory Helicobacter pylori infection, or who are re-infected after standard therapy. Drugs 1999; 57:905-20.
  109. Deltenre M; Geboes K; Ectors N et al. The 1998 national Belgian consensus meeting on H. PYLORI-related diseases: an extensive summary. The H. PYLORI Belgian contact group organized in CHU Brugmann, Brussels. Acta Gastroenterol Belg 1998; 61:299-302.
  110. Van Doorn LJ, Schneeberger PM, Nouhan N et al. Importance of Helicobacter pylori cagA and vacA status for the efficacy of antibiotic treatment. Gut 2000; 46:321-6.
  111. Broutet N, Marais A, Lamouliatte H et al. CagA status and eradication treatment outcome of anti-Helicobacter pylori triple therapies in patients with non-ulcer dyspepsia. J Clin Microbiol 2001; 39:1319-22.
  112. Dette GA & Knothe H. Kinetics of erythromycin uptake and release by human lymphocytes and polymorphonuclear leucocytes. J Antimicrob Chemother 1986; 18:73-82.
  113. Queiroz DMM, Dani R, Silva LD et al. Factors associated with treatment failure of Helicobacter pylori infection in a developing country. J Clin Gastroenterol 2002; 35:315-20.
  114. Matsuoka M, Yoshida Y, Hayakawa K et al. Simultaneous colonisation of Helicobacter pylori with and without mutations in the 23Sr RNA gene in patients with no history of clarithromycin exposure. Gut 1999; 45:503-507.
  115. Wang GE, Wilsoon TJM, Jiang Q, Taylor DE. Spontaneous mutations that confer antibiotic resistance in Helicobacter pylori. Antimicrob Agents Chemother 2001; 45:727-33.
  116. Jaup BH, Brandberg A, Stenquist B et al. Antibiotic resistance among strains of Helicobacter pylori in Gothernburg. Bacteria resistant to metronidazole. Lakartidnigen 1998; 95:279-81.
  117. Adamek RJ, Suerbaum S, Pfaffenbach B et al. Primary and acquired Helicobacter pylori resistance to clarithromycin, metronidazole and amoxicillin-influence on treatment outcome. Am J Gastroenterol 1998; 93:386-9.
  118. Van Zwet AA, Vandenbroucke-Grauls CM, Thijs JC et al. Stable Amoxicillin resistance in Helicobacter pylori (letter). Lancet 1998; 352:1599.
  119. Megraud F, Lehn N, Lind T et al. The MACH 2 Study. Helicobacter pylori resistance to antimicrobial agents and its influence on clinical outcome. Gastroenterology 1997, 112:A1622 (Abstract).
  120. Xia HK, Buckley M, Keane CT, O´Morain CA. Clarithromycin resistance in Helicobacter pylori: prevalence in untreated dyspeptic patients and stability in vitro. J Antimicrob Chemother 1996; 37:473-81.
  121. Pilotto A, Leandro G, Franceschi M et al. The effect of antibiotic resistance on the outcome of three 1-week triple therapies against Helicobacter pylori. Aliment Pharmacol Ther 1999; 13:667-76.
  122. Megraud F. Antibiotic resistance in Helicobacter pylori infection. Br Med Bull 1998; 54:207-16.
  123. Bontems P, Devaster JM, Corvaglia L et al. Twelve year observation of primary and secondary antibiotic-resistant Helicobacter pylori strains in children. Pediatr Inf Dis 2001; 20:1033-8.
  124. Kalach N, Bergeret M, Benhamou P et al. High levels of resistance to metronidazole and clarithromycin in Helicobacter pylori strains in children. J Clin Microbiol 2001; 39:394-7.
  125. Megraud F. Rationale for the choice of antibiotics for eradication of Helicobacter pylori. Eur J Gastroenterol 1995; 7:49-54.
  126. Wolle K, Nilius M, Muller WA et al. Prevalence of Helicobacter pylori resistance to several antimicrobial agents in a region of Germany. Eur J Clin Microbiol Infect Dis 1998, 17:519-21.
  127. Miyaji H, Azuma T, Ito S et al. Susceptibility of Helicobacter pylori isolates to metronidazole, clarithromycin and amoxycillin in vitro and in clinical treatment in Japan. Aliment Pharmacol Ther 1997; 11:1131-6.
  128. Morton D, Ahmed R, Alley R et al. Helicobacter pylori antimicrobial susceptibilities: A tale of two cities. Gastroenterology 1998; 114:A954-5 (abstract).
  129. Lopez-Brea M, Domingo D, Sanchez I et al. Evolution of resistance to metronidazole and clarithromycin in Helicobacter pylori clinical isolates from Spain. J Antimicrob Chemother 1997;40:279-81.
  130. Weissfeld AS, Simmons DE, Vance PH et al. In vitro susceptibility of pre-treatment isolates of Helicobacter pylori from two multicenter United States clinical trials. Gastroenterology 1996; 110:A295(abstract).
  131. Van der Wouden EJ, Van Zwet AA, Thijs JC et al. Rapid increase in the prevalence of metronidazole-resistant Helicobacter pylori in the Netherlands. Emerg Infect Dis 1997; 3:385-9.
  132. Banavala N, Davies GR, Abdi Y et al. High prevalence of Helicobacter pylori metronidazole resistance in migrants to east London: relation with previous nitroimidazole exposure and gastroduodenal disease. Gut 1994; 35:1562-6.
  133. Reddy R, Osato M, Gutierrez O et al. Metronidazole resistance is high in Korea and Colombia and appears to be rapidly increasing in the US. Gastroenterology 1996, 110:A238(abstract).
  134. Wu H, Shi XD, Wang HY, Liu JX. Resistance of Helicobacter pylori to metronidazole, tetracycline and amoxycillin. J Antimicrob Chemother 2000; 46:121-3.
  135. Mendonça S, Ecclissato C, Sartori MS et al. Prevalence of Helicobacter pylori resistance to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone in Brazil. Helicobacter 2000; 5:79-83.
  136. Queiroz DMM, Coimbra RS, Mendes EN et al. Metronidazole resistant Helicobacter pylori in a developing country. Am J Gastroenterol 1993; 88:322-3.
  137. Bocr WA. How to Achieve a near 100% cure rate for H. Pylori infection in Peptic Ulcer Patients. J Clin Gastroenterol 1996; 22:313.
  138. Vyas SP, Sihorkar V. Exploring novel vaccines against Helicobacter pylori: protective and therapeutic immunization. J Clin Pharm Ther 1999;24:259-72.
  139. Rino R, Duccio B, Samuele P et al. New strategies for the prevention and treatment of Helicobacter pylori infection. Expert Opinion on Investigational Drugs 2002; 11:1127-38.
  140. Coelho LGV, Leon-Barua R, Quigley EMM et al. Latin-American Consensus conference on Helicobacter pylori infection. Am J Gastroenterol 2000; 95:2688-91.
Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

  English title
 Abstract
 Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia

Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008