{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T04:20:38Z","timestamp":1762057238968,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The efficacy of Helicobacter pylori (H. pylori) eradication therapy for children is currently low, and antibiotic resistance is a significant cause of treatment failure. The purpose of this study was to evaluate the H. pylori eradication efficacy of therapy based on antimicrobial susceptibility in pediatric patients with gastritis and peptic ulcer. Methods: This study was conducted at Can Tho Children\u2019s Hospital and Can Tho University of Medicine and Pharmacy Hospital between March 2019 and April 2022. We performed an upper gastrointestinal endoscopy, cultured H. pylori from biopsies of gastric mucosa, determined antibiotic sensitivities to H. pylori by the E-test method, and treated eradication based on the antibiotic susceptibilities of bacteria. After at least 4 weeks of eradication therapy, we assessed the effectiveness of treatment with a breath test. Results: Among 237 children recruited in this study, 48.9% were boys and 51.1% were girls, and the mean age was 10.03 \u00b1 2.53 years. We determined that 80.6% of H. pylori were resistant to clarithromycin, as well as amoxicillin, metronidazole, levofloxacin, and tetracycline, at 71.7%, 49.4%, 45.1%, and 11.4%, respectively. The overall eradication rate of H. pylori was 83.1% (172\/207). Among therapies tailored to antimicrobial susceptibility, the bismuth quadruple regimen achieved the greatest success, but the efficacy of triple therapy with esomeprazole + AMX + CLR\/MTZ was low. Conclusions: Tailored eradication therapy was highly successful in our study but did not achieve over 90%. We recommend that in countries with a high prevalence of antibiotic resistance in H. pylori strains, particularly where the amoxicillin-resistance rate of H. pylori is high, therapy tailored to antimicrobial susceptibility should be used as first-line therapy, and bismuth and tetracycline should be added to enhance the eradication efficacy in children.<\/jats:p>","DOI":"10.3390\/children9071019","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T11:37:08Z","timestamp":1657280228000},"page":"1019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Helicobacter pylori Eradication Efficacy of Therapy Based on the Antimicrobial Susceptibility in Children with Gastritis and Peptic Ulcer in Mekong Delta, Vietnam"],"prefix":"10.3390","volume":"9","author":[{"given":"Loan T. T.","family":"Le","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuan A.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nghia A.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen T. H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai T. B.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liem T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6287-9722","authenticated-orcid":false,"given":"Mai T.","family":"Vi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7799-4523","authenticated-orcid":false,"given":"Thang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1053\/j.gastro.2015.09.004","article-title":"Pathobiology of Helicobacter pylori-induced Gastric Cancer","volume":"150","author":"Amieva","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_2","unstructured":"World Gastroenterology Organisation (2021). World Gastroenterology Organisation Global Guidelines. Helicobacter pylori, World Gastroenterology Organisation."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3565","DOI":"10.31557\/APJCP.2018.19.12.3565","article-title":"Helicobacter pylori Infection and Related Gastrointestinal Diseases in Southeast Asian Countries: An Expert Opinion Survey","volume":"19","author":"Quach","year":"2018","journal-title":"Asian. Pac. J. Cancer Prev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1097\/MPG.0000000000001594","article-title":"Joint ESPGHAN\/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)","volume":"64","author":"Jones","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_5","first-page":"65","article-title":"How and when investigating and treating Helicobacter pylori infection in children","volume":"89","author":"Manfredi","year":"2018","journal-title":"Acta Biomed."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.4236\/aim.2017.74020","article-title":"Antibiotic Resistance of Helicobacter pylori and Eradication Rate in Japanese Pediatric Patients","volume":"07","author":"Ikuse","year":"2017","journal-title":"Adv. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e12400","DOI":"10.1111\/hel.12400","article-title":"Antibacterial resistance and the success of tailored triple therapy in Helicobacter pylori strains isolated from Slovenian children","volume":"22","author":"Butenko","year":"2017","journal-title":"Helicobacter"},{"key":"ref_8","first-page":"41","article-title":"Effectiveness of eradication regimen based on the bacterial susceptibility and CYP2C19 genotype in children with refractory Helicobacter pylori infection","volume":"58","author":"Zhang","year":"2020","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"ref_9","unstructured":"European Committee on Antimicrobial Susceptibility (2019). Breakpoint Tables for Interpretation of MICs and Zone Diameters European Committee on Antimicrobial Susceptibility Testing, European Committee on Antimicrobial Susceptibility, EU."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1111\/ped.14388","article-title":"The updated JSPGHAN guidelines for the management of Helicobacter pylori infection in childhood","volume":"62","author":"Kato","year":"2020","journal-title":"Pediatrics Int."},{"key":"ref_11","first-page":"383.e1","article-title":"Management of Helicobacter pylori infection in the pediatric age","volume":"95","author":"Poblet","year":"2021","journal-title":"An. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e123832","DOI":"10.1111\/hel.12383","article-title":"Eradication rate of Helicobacter Pylori infection is directly influenced by adherence to therapy in children","volume":"22","author":"Kotilea","year":"2017","journal-title":"Helicobacter"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e12528","DOI":"10.1111\/hel.12528","article-title":"Helicobacter pylori antimicrobial resistance in a pediatric population","volume":"23","author":"Silva","year":"2018","journal-title":"Helicobacter"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.kjms.2013.11.003","article-title":"Eradication of Helicobacter pylori infection","volume":"30","author":"Marcus","year":"2014","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1517\/14728222.2015.1073261","article-title":"Effect of bacterial and host factors on Helicobacter pylori eradication therapy","volume":"19","author":"Uotani","year":"2015","journal-title":"Expert Opin. Targets"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1053\/j.gastro.2020.11.059","article-title":"AGA Clinical Practice Update on the Management of Refractory Helicobacter pylori Infection: Expert Review","volume":"160","author":"Shah","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_17","first-page":"1417","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing","volume":"109","author":"Lima","year":"2021","journal-title":"Clin. Pharmacol."},{"key":"ref_18","unstructured":"Tran, L.D. (2019). Research on the Situation, Clinical and Subclinical Characteristics and Evaluation of Results of Treatment for Eradication of Helicobacter pylori in Children with Gastritis and Peptic Ulcers at Can Tho Children\u2019s Hospital in 2017\u20132019. [Master\u2019s Thesis, Can Tho University of Medicine and Pharmacy]."},{"key":"ref_19","unstructured":"Nguyen, U.T. (2016). Epidemiological, Clinical Characteristics and Results of Some Regimens for the Treatment of Peptic Ulcer and Peptic Ulcer Caused by Antibiotic-Resistant Helicobacter pylori in Children at the National Children\u2019s Hospital. [Ph.D. Thesis, Central Institute of Hygiene and Epidemiology]."},{"key":"ref_20","unstructured":"Le, T., and Ngoc, C. (2018). Characteristics of Antibiotic Resistance and Response to Treatment in Children with Gastritis Caused by Helicobacter pylori at Children\u2019s Hospital 2. [Specialized Thesis II, Ho Chi Minh City University of Medicine and Pharmacy]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5455\/medarh.2021.75.112-115","article-title":"Antimicrobial Resistance and the Successful Eradication of Helicobacter pylori-induced Gastroduodenal Ulcers in Vietnamese Children","volume":"75","year":"2021","journal-title":"Med. Arch."},{"key":"ref_22","first-page":"1","article-title":"Antibiotic resistance of Helicobacter pylori strain in children\u2019s gastritis","volume":"4","author":"Thanh","year":"2020","journal-title":"J. Pediatric Res. Pract."},{"key":"ref_23","unstructured":"Nayoung, K. (2016). Helicobacter Pylori, Springer."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/MCG.0b013e318247177e","article-title":"Predicting Helicobacter pylori eradication: How to teach an old dog new tricks!","volume":"46","author":"Zullo","year":"2012","journal-title":"J. Clin. Gastroenterol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/1019\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:46:49Z","timestamp":1760140009000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/1019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,8]]},"references-count":24,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["children9071019"],"URL":"https:\/\/doi.org\/10.3390\/children9071019","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,7,8]]}}}