A.A. KAMALOVA, I.M. URAZMANOVA, A.A. KHAFIZOVA, I.I. FATTAKHOVA

Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

 Contact details:

Kamalova A.A. — MD, Professor of the Department of Hospital Pediatrics

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 237-30-37, e-mail: aelitakamalova@gmail.com

 The article presents an adapted translation of updated joint recommendations of the European and North American societies of European Society for Paediatric Gastroenterology, Hepatology and Nutrition for the diagnosis and treatment of Helicobacter pylori infection in children and adolescents. The need for their creation was dictated by a change of the epidemiology of Н. pylori infection and the low efficiency of the currently used treatment methods. Experts recommend conducting an invasive diagnosis of Н. pylori infection only in cases where it is intended to prescribe therapy, as well as in the detection of erosive and ulcerative defects of the gastric mucosa and duodenum. In order to achieve the level of eradication using first-line therapy, in 90% of cases and more, antibiotics should be prescribed taking into account the antibiotic sensitivity of the selected Н. pylori strain. It is recommended to take antibiotics for 14 days. Children with resistant Н. pylori strains are not prescribed a regimen involving clarithromycin. If the antibiotic sensitivity spectrum is unknown, a three-component eradication regimen with high doses of a proton pump inhibitor, amoxicillin and metronidazole for 14 days or four-component therapy with bismuth-containing drugs is preferred. The effectiveness of treatment is recommended to be evaluated after 4–8 weeks using reliable non-invasive methods.

Conclusions. The main purpose of the clinical examination is to identify the causes of the symptoms of the disease of the upper gastrointestinal tract, and not to determine the infection of Н. pylori. Therefore, the «test Н. pylori and treat» strategy should not be used in pediatric practice. The use of previously recommended treatment regimens revealed a decrease of the successful infection eradication, which required a review of existing first-line therapy and the wider use of cultural or molecular diagnostic methods. In conclusion, experts emphasize the need for regional studies of the effectiveness of the proposed first-line eradication therapy.

Key words: adolescents, antibiotic sensitivity, urease breath test, children, eradication, Helicobacter pylori, triple therapy.

 (For citation: Kamalova A.A., Urazmanova I.M., Khafizova A.A., Fattakhova I.I. Current international recommendations for the diagnosis and treatment of Helicobacter pylori infection in children and adolescents (short version of Joint ESPGHAN / NASPGHAN guidelines for the management of Helicobacter pylori in children and adolescents, update 2016). Practical Medicine. 2019. Vol. 17, № 5, P. 219-227)

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