Total Family Unit Helicobacter pylori Eradication and Pediatric Re-Infection Rates

ABSTRACT Background. Re‐infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re‐infection and if eradication of H. pylori from the entire family reduces the risk of childhood re‐infection. Methods. Fifty families, each with an H. pylori‐infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a ‘family unit treatment’ group (all infected family members treated) or an ‘index case treatment’ group (index case only treated). Results. At long‐term follow‐up (mean 62.2 months), there were three re‐infected children in the ‘index case treatment’ group compared with one in the ‘family unit treatment’ group. The re‐infection rate was 2.4% per patient per year in the ‘index case treatment’ group and 0.7% per patient per year in the ‘family unit treatment’ group (p = .31). Conclusions. This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re‐infection rates and reports the longest period of re‐infection follow‐up in children. In childhood, re‐infection with H. pylori is not significantly reduced by family unit H. pylori eradication.