Triple Therapy for Helicobacter pylori Eradication Safe for Adolescents

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A team of investigators conducted a prospective, multicenter study to assess the safety of H pylori eradication therapy in adolescent students.

A triple-therapy regimen for eradication of Helicobacter pylori was found to be safe for adolescents, according to the results of a prospective, multicenter study that were published in Scientific Reports.

Students (N=151) attending junior high school in Japan in 2016 were recruited for this study. The students were tested for H. pylori through urine and stool samples. Those who were positive (n=31) underwent a triple-therapy eradication regimen consisting of vonoprazan fumarate (20mg), amoxicillin (750mg), and clarithromycin (200mg) twice a day for 7 days. Students provided stool samples at 1 to-2 days and again at 8 to 12 weeks after therapy. Eradication was assessed at 8 to 12 weeks by 13C-urea breath test.

A total of 29 students provided the first stool sample, 26 the second, and 19 the third. Of the students who provided all samples, 3 were considered treatment failures.

Among the 16 students with treatment success and sufficient data, 9 were boys aged median 15.6 years.

Following eradication, the proportion of Actinobacteria was significantly reduced (P =.006924) but increased at 8 to 12 weeks (P =.047065) to a similar level as before treatment (P =.214554). Coriobacteriaceae decreased in abundance after eradication (P =.008656).

After eradication, significant reductions to phylogenetic richness (P =.003), microbiota diversity (P =.023), and microbial species richness (P =.003) were observed. At 8 to 12 weeks, significant differences were not observed, indicating microbiota diversity recovery over time.

The adverse events reported were abdominal pain among 2 students and diarrhea in 1 student.

This study was limited by its low sample size, its low retention rate, and the choice to not include a control condition with which to make comparisons.

These data indicated a triple-therapy regimen of vonoprazan fumarate, amoxicillin, and clarithromycin for the eradication of H. pylori was safe for use among adolescents. No evidence of alterations to the overall diversity of gut microbiota was observed, justifying additional longer-term studies among a larger population.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Kakiuchi T, Yamamoto K, Imamura I et al. Gut microbiota changes related to Helicobacter pylori eradication with vonoprazan containing triple therapy among adolescents: a prospective multicenter study. Sci Rep. 2021;11(1):755. doi:10.1038/s41598-020-80802-3

This article originally appeared on Gastroenterology Advisor