A new sequential therapy including bismuth for 14 days can be used as first-line therapy in children as it offers a high rate of Helicobacter pylori (H. pylori) elimination.

A retrospective study was conducted to explore whether the new sequential therapy containing bismuth is effective to treat H.pylori infection in children.

In this study, 75 patients (more than eight years of age, mean age 15.1 ± 2.4 years) suffering from H. pylori gastritis were included. As per Rome IV criteria, 38 subjects had dyspepsia and functional abdominal pain, and 37 subjects had alarm findings depicting organic disease.

Participants were treated with a new sequential therapy consisting of lansoprazole, amoxicillin for seven days. This was subsequently followed by lansoprazole, metronidazole, tetracycline, and bismuth subsalicylate. The eradication status was estimated by the H. pylori stool antigen test eight weeks after completion of the therapy.

No participant discontinued treatment due to adverse effects. All participants had antral gastritis (76.0%) or pangastritis (24.0%). The peptic ulcer rate was about 6.6%. Eradication therapy was administered to all patients with or without peptic ulcer. The elimination of H pylori eradication was attained in 69 (92.0%) patients and symptoms improved in 61 (81%) of those eradicated patients.

In children, a new sequential therapy including bismuth for 14 days is a promising therapeutic approach to treat H. pylori infection.