[Helicobacter pylori eradication therapy in children].

Proton pump inhibitor-based triple therapies are performed worldwide for Helicobacter pylori-associated diseases in childhood. As the first-line therapy, the Japanese Pediatric Guideline in H. pylori Infection has recommended a triple regimen with amoxicillin and clarithromycin, because the Japanese national health care insurance system has permitted only this regimen. However, the primary resistance to clarithromycin in Japan is demonstrated in around 30% of the strains, leaving an urgent issue for the physicians. A triple regimen with amoxicillin and metronidazole is acceptable as the second-line therapy. In children with chronic H. pylori gastritis, eradication should be considered if they have gastric atrophy or a family history of gastric cancer. In children, however, a 'test and treat' strategy to prevent gastric cancer is not recommended.