Optimization of eradication treatment for chronic gastroduodenitis associated with Helicobacter pylori in children using spore recombinant probiotic based on Bacillus subtilis
Background. The relevance is associated with a significant spread of Helicobacter pylori (Hp) in children in Ukraine. Chronic gastroduodenitis is the main nosology in children associated with Hp, which requires comprehensive treatment, first of all eradication one. To optimize the effective use of eradication schemes, current international recommendations provide for the possibility of prescribing probiotics. The purpose of the study was to evaluate the influence of Subalin probiotic on eradication efficacy and tolerability of anti-Helicobacter therapy in children aged 12–18 years with Hp-positive chronic gastroduodenitis. Materials and methods. Design: a single-center open comparative study. The study included 50 children with Hp-associated chronic gastroduodenitis aged 12 to 18 years. Patients are divided into 2 groups depending on the probiotic administration. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp infection. The results were recorded in a specially developed individual patient’s chart and statistically processed. Results. The results of using Subalin probiotic in patients of the main group concomitantly with the standard first-line pediatric schemes of Hp eradication in children and adolescents with Hp-positive forms of chronic gastroduodenitis indicate the advisability, effectiveness and prospects of such treatment. This is confirmed by the positive dynamics of complaints, the absence of side effects (including antibiotic-associated diarrhea), and good tolerability of drugs in triple or quadruple therapy regimens against the background of receiving spore recombinant probiotic in the vast majority of patients. Patients from the comparison group also had a positive dynamics in the main complaints, but less pronounced. However, the worsening of tolerability and side effects from standard eradication schemes were significantly more frequent (on average 35–40 %) compared with main group. In addition, administration of Subalin increases by 5 % the efficiency of eradication of standard first-line anti-Hp regimens. Conclusions. The use of spore recombinant probiotic Subalin together with standard eradication schemes in children from 12 years of age is advisable, since it allows increasing the eradication efficiency by 5 %, improving the tolerability of anti-Hp drugs and, accordingly, the adherence of patients to the treatment and recommendations. The possibility of using Bacillus subtilis already at the first stage of treatment helps to optimize therapeutic measures in older children with Hp-positive variants of chronic gastroduodenitis.
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