An open-label randomized controlled trial comparing the efficacy and safety of a 7-day triple therapy with bismuth versus 14-day standard triple therapy for Helicobacter pylori eradication in children and adolescentsŠterbenc, Anja (Avtor) Vratanar, Bor (Avtor) Miler Mojškerc, Eva (Avtor) Homan, Matjaž (Avtor) treatmenteradicationHelicobacter pyloribismuthchildrenBackground: To achieve eradication rates >90%, the ESPGHAN/NASPGHAN guidelines for pediatric Helicobacter pylori infection recommend tailored antimicrobial therapy using sufficiently high doses over 10–14days. However, prolonged treatment often leads to suboptimal compliance in children, which is a major contributor to reduced eradication rates. To address this, we evaluated the efficacy and safety of a shorter, 7day triple therapy with bismuth compared with the 14day standard triple therapy without bismuth in H. pylori infected children. Materials and Methods: From 2020 to 2024, we carried out a randomized controlled trial involving treatment-naïve children and adolescents (5–18 years old) with confirmed H. pylori infection. Eligible participants were randomly allocated to receive either a 7day triple therapy with bismuth (bismuth subcitrate, a proton pump inhibitor [PPI], amoxicillin, plus clarithromycin/ metronidazole) or a 14day standard triple therapy (a PPI, amoxicillin, plus clarithromycin/metronidazole) without bismuth. Two months after completing therapy, treatment success was determined using either a two-step monoclonal stool antigen assay or a urea breath test. Any adverse events were documented using a structured questionnaire. Results: Seventy-three children were enrolled in the study. In the intention-to-treat analysis, eradication was achieved in 91% of children treated with the 7day triple therapy with bismuth and 87% of those receiving the 14day standard triple therapy (p=0.695). Per-protocol eradication rates were 94% and 87%, respectively (p=0.418). No serious adverse events were reported, and most adverse events were mild to moderate. A metallic taste was significantly more frequent in the 14day standard triple therapy group, while other adverse events occurred with similar frequency. Conclusions: Adding bismuth to a 7day triple regimen achieved high eradication rates and a safety profile similar to 14day standard triple therapy, supporting its use as an effective and safe treatment option for pediatric H. pylori infection.20262026-01-12 13:19:23Članek v reviji177896UDK: 616.3ISSN pri članku: 1523-5378DOI: 10.1111/hel.70103COBISS_ID: 264152579sl