Kết quả điều trị Helicobacter pylori ở trẻ viêm loét dạ dày tá tràng tại Bệnh viện Nhi Đồng 2 năm 2024

Helicobacter pylori infection remains a significant global health concern, particularly in Vietnam where prevalence is high. It is a primary cause of gastritis, peptic ulcers, and is linked to gastric cancer. A pressing challenge in managing H. pylori infections is the escalating antibiotic resistance, making eradication increasingly difficult, especially in pediatric populations. Previous studies in Vietnam, including those at Children's Hospital 2, have reported concerningly low H. pylori eradication rates in children, highlighting the inadequacy of empirical treatments. This study addresses this critical issue by evaluating antibiotic resistance patterns and the effectiveness of first-line eradication regimens guided by susceptibility testing in children with gastroduodenal ulcers at Children's Hospital 2 in 2024, aiming to inform more effective therapeutic strategies.

Nghiên cứu sinh, bác sĩ nhi khoa, bác sĩ chuyên khoa tiêu hóa, dược sĩ lâm sàng và các nhà hoạch định chính sách y tế quan tâm đến điều trị H. pylori ở trẻ em và vấn đề kháng kháng sinh.

This cross-sectional study investigated `Helicobacter pylori` `antibiotic resistance` patterns and the efficacy of first-line treatment regimens guided by susceptibility testing in 136 children with gastritis and `peptic ulcer disease` at `Children's Hospital 2` in 2024. The patient cohort, with a mean age of 9.6 years, frequently presented with abdominal pain (93.4%) and a high incidence of family history of H. pylori infection (57.4%). Endoscopic findings predominantly revealed inflammatory lesions (81%) and ulcers (26.5%). Crucially, the study identified alarmingly high `antibiotic resistance` rates to commonly used antibiotics: clarithromycin (100%), amoxicillin (77.9%), and metronidazole (69.8%). In contrast, resistance to levofloxacin and tetracycline was considerably lower (31.6% and 2.2%, respectively). The overall H. pylori eradication rate achieved was 63.9%, with 77.9% of patients reporting symptom improvement. A significant association was observed between symptom improvement and successful eradication (OR = 5.31; p < 0.001). The findings underscore the critical need for adopting treatment strategies based on individual `antibiotic susceptibility testing` rather than empirical approaches, especially given the high resistance observed in this pediatric population. Implementing personalized treatment protocols, potentially involving high-dose amoxicillin or other effective regimens, is essential to enhance eradication success rates and improve clinical outcomes for children suffering from H. pylori-related gastroduodenal diseases.