Smjernice za dijagnozu i liječenje infekcije Helicobacterom pylori u djece i adolescenata

Professional paper - Professional paper

• Author: Zrinjka Mišak
• Author: Iva Hojsak
• Author: Ranka Despot
• Author: Oleg Jadrešin
• Author: Sanja Kolaček
• Author: Vlatka Konjik
• Author: Goran Palčevski
• Author: Ana Močić Pavić
• Author: Irena Senečić-Čala
• Author: Duška Tješić-Drinković
• Author: Jurica Vuković
• Author: Orjena Žaja
• Author's institution: University of Zagreb; School of Medicine; (Department of Pediatrics)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract (croatian)

Obilježja infekcije Helicobacterom (H.) pylori kod djece razlikuju se od infekcije u odraslih pa su tako i dijagnostički i terapijski pristupi različiti. Osim toga, brojni podatci ukazuju na zabrinjavajući porast rezistencije na antibiotike i na nezadovoljavajuću stopu eradikacije H. pylori u dječjoj dobi. Zbog svega toga, a i budući da u Hrvatskoj postoje samo smjernice za odrasle, javila se potreba za smjernicama o dijagnozi i liječenju infekcije H. pylori kod djece i adolescenata. Pristup... More “testiraj i liječi” nije opravdan u dječjoj populaciji. Dijagnostičke se pretrage trebaju usmjeriti na otkrivanje uzroka simptoma, a ne na traženje H. pylori. Dijagnozu infekcije treba temeljiti na pozitivnom mikrobiološkom nalazu kulture ili kombinaciji nalaza bakterije u histopatološkom preparatu uz još jedan pozitivan test u bioptatu. Eradikacijska terapija treba se temeljiti na antimikrobnoj osjetljivosti/rezistenciji, koristeći dovoljno visoke doze lijekova tijekom 14 dana. Ako je osjetljivost na antibiotike nepoznata, prva linija terapije uključuje visoku dozu inhibitora protonske pumpe, amoksicilin i metronidazol kroz 14 dana. Nakon provedenog liječenja treba provjeriti eradikaciju koristeći ili C13-urejni izdisajni test ili dokazivanjem antigena u stolici, najmanje četiri tjedna nakon završetka terapije. U slučaju neuspjele eradikacije koristi se druga linija terapije uzimajući u obzir već korištene antibiotike u prvoj liniji i trajanje terapije, a terapiju treba temeljiti na antibiogramu ako je moguće. Less

Abstract (english)

The characteristics of Helicobacter (H.) pylori infection in children differ from the infection in adults,
so diagnostic and treatment approaches are different. In addition, numerous data point to a worrying increase
of antibiotic resistance and unsatisfactory eradication rate of H. pylori in children. Due to all this, and since
there are only guidelines for adults in Croatia, there is a need for recommendation on diagnosis and treatment
of H. pylori infection in children and... More adolescents. The approach “test and treat” is not justified in children. Diagnostic tests should focus on detecting the cause of symptoms, and not on searching for H. pylori. The diagnosis of
infection should be based on positive culture or a combination of finding bacteria on histopathology and one
more positive biopsy-based test. The eradication treatment should be based on antimicrobial sensitivity/resistance, using adequate therapy dosages for 14 days. If sensitivity for antibiotics is not known, the first line of
therapy includes high dosage of proton pump inhibitors, amoxicillin and metronidazol for 14 days. After treatment, the eradication should be checked using C13-urea breath test or stool antigen test, at least four weeks after
therapy. In case of unsuccessful eradication, the second line treatment is used, taking into account antibiotics
already used as the first line, duration of therapy, and if possible the treatment should be based on culture and
antibiotic sensitivity. Less

• Keywords (croatian): Deskriptori HELICOBACTER PYLORI INFEKCIJE – dijagnoza, farmakoterapija; HELICOBACTER PYLORI – djelovanje lijeka, izolacija; REZISTENCIJA BAKTERIJA NA LIJEKOVE; PROTUBAKTERIJSKI LIJEKOVI – terapijska uporaba; INHIBITORI PROTONSKE PUMPE – terapijska uporaba; KOMBINIRANA FARMAKOTERAPIJA; RASPORED PRIMJENE LIJEKOVA; DJECA; HRVATSKA; SMJERNICE
• Keywords (english): HELICOBACTER INFECTIONS – diagnosis, drug therapy; HELICOBACTER PYLORY – drug effects, isolation and purification; DRUG RESISTANCE, BACTERIAL; ANTI-BACTERIAL AGENTS – therapeutic use; PROTON PUMP INHIBITORS – therapeutic use; DRUG THERAPY, COMBINATION; DRUG ADMINISTRATION SCHEDULE; CHILD; CROATIA; PRACTICE GUIDELINES AS TOPIC
• Language: croatian
• Publication type: Professional paper - Professional paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 144, no. 7-8, pp. 197-206
• p-ISSN: 0024-3477
• e-ISSN: 1849-2177
• DOI: https://doi.org/10.26800/LV-144-7-8-1
• URN:NBN: urn:nbn:hr:105:206715
• Publication: 2022
• Document URL: https://hrcak.srce.hr/281212
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-01-24 11:51:39