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:

• Quadruple Therapy for Helicobacter Pylori Favored in Toronto Guidelines
• ACG Guideline for Helicobacter Pylori | gutsandgrowth

Other related posts

• Understanding Resistance to Helicobacter pylori | gutsandgrowth
• Salvage Therapy and Standard Therapy for H pylori | gutsandgrowth
• High Rates of Helicobacter Pylori Resistance | gutsandgrowth
• What is evidence-based medicine for H pylori? gutsandgrowth
• H pylori –useful advice gutsandgrowth
• Twyman’s Law | gutsandgrowth