Updated Pediatric Helicobacter Pylori Guidelines

Joint ESPGHAN/NASPGHAN guidelines (NL Jones et al. JPGN 2017; 64: 991-1003) have been published.  Overall, these guidelines cover a great deal of information.  It is interesting that these guidelines provide some conflicting advice with recommendations for adults.

  • Some recommendations:
    The authors recommend against diagnostic testing H pylori in children with functional abdominal pain
  • The authors recommend against using antibody-based tests from blood, urine, or saliva.
  • The authors recommend noninvasive testing for H pylori when investigating chronic immune thrombocytopenic purpura (ITP)
  • First line therapy recommendations if sensitivity is unknown: High-dose PPI-Amoxicillin-Metronidazole for 14 days OR Bismuth-based quadruple therapy (in children less than 8 years, quadruple therapy would be bismuth, PPI, amoxicillin and metronidazole; in older children it is recommended to substitute tetracycline for amoxicillin).  Specific dosing is given in this report (Table 3 and Table 4)
  • The authors recommend assessing for infection eradication at least 4 weeks after completion of therapy

My take: I favor quadruple therapy for most patients (see adult guidelines below) until sensitivities can be more easily obtained.  If you know of a reliable lab to obtain culture sensitivities, please let me know.

Related blog posts:

Adult Guidelines:

Other related posts

5 thoughts on “Updated Pediatric Helicobacter Pylori Guidelines

  1. I believe these guidelines continue to recommend biopsy proof/assessment when suspected H. pylori (positive breath test or stool), curious how many do this?

    I’ve had some success using this lab for C/S, I think their in your neighborhood: https://drglab.com/

    They have a kit…..just need to keep a few in endo unit.

  2. Pingback: Lots of Room to Improve with H pylori Treatment | gutsandgrowth

  3. Pingback: Why Is There Low Adherence to H pylori Guidelines? | gutsandgrowth

  4. Pingback: Next-Generation Treatment for H Pylori | gutsandgrowth

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.