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Please select the corresponding answer to get the dosing regimen calculated.
Based on the answer, the recommended options for first line therapy for H. pylori is:
Please input the child's weight to calculate the dosing regimen.
Bodyweight range | Morning dose | Evening dose |
---|---|---|
15 to 24 kg | 750mg | 750mg |
25 to 34 kg | 1000mg | 1000mg |
>35 kg | 1500mg | 1500mg |
1. We recommend that the primary goal of clinical investigation of gastrointestinal symptoms should be to determine the underlying cause of the symptoms and not solely the presence of H pylori infection.
2a. We recommend that during endoscopy additional biopsies for RUT and culture should only be taken if treatment is likely to be offered if infection is confirmed.
2b. We suggest that if H pylori infection is an incidental finding at endoscopy, treatment may be considered after careful discussion of the risks and benefits of H pylori treatment with the patient/parents.
2c. We recommend against a ‘‘test and treat’’ strategy for H pylori infection in children.
3. We recommend that testing for H pylori be performed in children with gastric or duodenal ulcers. If H pylori infection is identified then treatment should be advised and eradication be confirmed.
4. We recommend against diagnostic testing for H pylori infection in children with functional abdominal pain.
5a. We recommend against diagnostic testing for H pylori infection as part of the initial investigation in children with iron deficiency anemia.
5b. We suggest that in children with refractory IDA in which other causes have been ruled out, testing for H pylori during upper endoscopy may be considered.
6. We suggest that noninvasive diagnostic testing for H pylori infection may be considered when investigating causes of chronic immune thrombocytopenic purpura (ITP).
7. We recommend against diagnostic testing for H pylori infection when investigating causes of short stature.
8. We recommend that before testing for H pylori, waiting at least 2 weeks after stopping proton pump inhibitor (PPI) and 4 weeks after stopping antibiotics.
9a. We recommend that the diagnosis of H pylori infection should be based on either (a) histopathology (H pylori–positive gastritis) plus at least 1 other positive biopsy-based test or (b) positive culture.
9b. We recommend that for the diagnosis of H pylori infection at upper gastrointestinal endoscopy, at least 6 gastric biopsies be obtained.
10. We recommend against using antibody-based tests (IgG, IgA) for H pylori in serum, whole blood, urine, and saliva in the clinical setting.
11. We recommend that antimicrobial sensitivity be obtained for the infecting H pylori strain (s), and eradication therapy tailored accordingly.
12. We recommend that the effectiveness of first-line therapy be evaluated in national/regional centers.
13. We recommend that the physician explain to the patient/family the importance of adherence to the anti–H pylori therapy to enhance successful eradication.
14. We recommend first-line therapy for H pylori infection as listed in Table 2.
15. We recommend that the outcome of anti–H pylori therapy be assessed at least 4 weeks after completion of therapy using one of the following tests. (a) The 13C-urea breath (13C-UBT) test or (b) a 2-step monoclonal stool antigen test.
16. We recommend that when H pylori treatment fails, rescue therapy should be individualized considering antibiotic susceptibility, the age of the child, and available antimicrobial options.
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