what is the best drug for treating h pylori related ulcer in a 6 yr old child?

Question

A 6 yr old child was detected with a chronic duodenal ulcer last year and was attributed to h pylori.

Answer 1

Go to a doctor! As much as I think this site is great -- you don't want to be messing with bacterial-related duodenal ulcer treatment on Y! Answers.

Answer 2

Helicobacter Pylori is a bacteria that can be very persistent, it takes an antibiotic, ask a doctor. My sister in law had ulcers for years, they finally found out it was H Pylori, her doctor gave her a really common antibiotic. Tetracycline, I think. The symptoms went away completely.

Answer 3

What are the treatment regimens used for H. pylori eradication?
Therapy for H. pylori infection consists of 10 days to 2 weeks of one or two effective antibiotics, such as amoxicillin, tetracycline (not to be used for children <12 yrs.), metronidazole, or clarithromycin, plus either ranitidine bismuth citrate, bismuth subsalicylate, or a proton pump inhibitor. Acid suppression by the H2 blocker or proton pump inhibitor in conjunction with the antibiotics helps alleviate ulcer-related symptoms (i.e., abdominal pain, nausea), helps heal gastric mucosal inflammation, and may enhance efficacy of the antibiotics against H. pylori at the gastric mucosal surface. Currently, eight H. pylori treatment regimens are approved by the Food and Drug Administration (FDA) (Table 1); however, several other combinations have been used successfully. Antibiotic resistance and patient noncompliance are the two major reasons for treatment failure. Eradication rates of the eight FDA-approved regimens range from 61% to 94% depending on the regimen used. Overall, triple therapy regimens have shown better eradication rates than dual therapy. Longer length of treatment (14 days versus 10 days) results in better eradication rates.

FDA-Approved Treatment Options
FDA-approved treatment options
Omeprazole 40 mg QD + clarithromycin 500 mg TID x 2 wks, then omeprazole 20 mg QD x 2 wks

-OR-

Ranitidine bismuth citrate (RBC) 400 mg BID + clarithromycin 500 mg TID x 2 wks, then RBC 400 mg BID x 2 wks

-OR-

Bismuth subsalicylate (Pepto Bismol®) 525 mg QID + metronidazole 250 mg QID + tetracycline 500 mg QID* x 2 wks + H2 receptor antagonist therapy as directed x 4 wks

-OR-

Lansoprazole 30 mg BID + amoxicillin 1 g BID + clarithromycin 500 mg TID x 10 days

-OR-

Lansoprazole 30 mg TID + amoxicillin 1 g TID x 2 wks**

-OR-

Rantidine bismuth citrate 400 mg BID + clarithromycin 500 mg BID x 2 wks, then RBC 400 mg BID x 2 wks

-OR-

Omeprazole 20 mg BID + clarithromycin 500 mg BID + amoxicillin 1 g BID x 10 days

-OR-

Lansoprazole 30 mg BID + clarithromycin 500 mg BID + amoxicillin 1 g BID x 10 days

*Although not FDA approved, amoxicillin has been substituted for tetracycline for patients for whom tetracycline is not recommended.
**This dual therapy regimen has restrictive labeling. It is indicated for patients who are either allergic or intolerant to clarithromycin or for infections with known or suspected resistance to clarithromycin.

I am a Gastroenterology nurse

Tetracycline is not used in children as it results in discoloration of teeth. ***
No matter how you treat it or what particular medication the physician prescribes, this is a rough treatment even for an adult.


Hope this helps.

Answer 4

I don't know about the best drug but she needs to be on an antibiotic.