Nifuratel-Containing Initial Anti-Helicobacter pylori Triple Therapy in Children

Background: Proton pump inhibitor‐containing triple therapy with amoxicillin and metronidazole is recommended as initial treatment of Helicobacter pylori in childhood. However, eradication rate with this “classic” regimen is relatively low in Russia. Aim: To evaluate empiric nifuratel, amoxicillin, and bismuth triple therapy for H. pylori gastritis in childhood. Materials and Methods: Pediatric outpatients with H. pylori‐associated chronic gastritis who underwent endoscopy for dyspeptic symptoms received the combination of bismuth subcitrate (8 mg/kg/day, q.d.s.), nifuratel (30 mg/kg/day, q.d.s.), and amoxicillin (50 mg/kg/day, q.d.s.) for 10 days. H. pylori status was determined before and after the treatment (in 4–6 weeks) by modified Giemsa staining. Results: Seventy‐three children (48 boys, 25 girls, age range 9–14) were entered. H. pylori was eradicated in 63 patients (86%; 95% confidence interval: 76.6–93.2; intention‐to‐treat and per protocol). There were no serious adverse reactions and were no withdrawals due to any side‐effects. All of side‐effects were self‐limiting (dark stools, urine discoloration, blackening of the tongue, and others). Conclusions: The combination of nifuratel, bismuth subcitrate, and amoxicillin was an effective and tolerable regimen for H. pylori eradication.