Assessment of treatment effectiveness, follow-up results, and recurrence patterns in children with Helicobacter pylori infection.
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BACKGROUND: Helicobacter pylori infection remains a prevalent chronic bacterial condition in children and is associated with significant long-term gastrointestinal complications, including peptic ulcer disease and an increased risk of gastric malignancy. Although standard triple therapy is widely used as first-line treatment, rising antimicrobial resistance and reinfection continue to challenge eradication success in children. This study aimed to evaluate the comparative effectiveness of two standard triple therapy regimens and to assess follow-up outcomes and recurrence patterns in children diagnosed with H. pylori infection. MATERIALS AND METHODS: This retrospective observational study was conducted at the Department of Pediatrics, Liuzhou People's Hospital, between January 2023 and December 2025. Children aged 4-13 years with confirmed H. pylori infection were included. Patients received either proton pump inhibitor (PPI) + amoxicillin + clarithromycin (n = 94) or PPI + metronidazole + clarithromycin (n = 34) for 10-14 days. Diagnosis and post-treatment assessment were performed using the ¹³C urea breath test (¹³C UBT), with histopathological confirmation in clinically indicated cases. Eradication was confirmed four weeks after completion of therapy. Follow-up evaluations were conducted at 6 and 12 months to monitor recurrence. Statistical analyses were performed using chi-square and independent t-tests, with p < 0.05 considered statistically significant. RESULTS: A total of 128 children were included in the analysis. The overall eradication rate was 79.7%. The amoxicillin-based regimen demonstrated higher efficacy (84.0%) compared with the metronidazole-based regimen (67.6%). Recurrence occurred in 13.7% of successfully treated patients, predominantly among children younger than 10 years. Most recurrence cases were identified between 6 and 12 months following confirmed eradication. CONCLUSION: Amoxicillin-based triple therapy achieved superior eradication rates compared to metronidazole-based therapy in this children's cohort. However, recurrence remains a clinically relevant concern, particularly in younger children. Structured long-term follow-up and region-specific antimicrobial resistance surveillance are essential to optimize treatment outcomes in children's H. pylori management.