The study’s goal was to evaluate the clinical presentation, endoscopic findings, antibiotic susceptibility, and treatment effectiveness in pediatric Helicobacter pylori (H. pylori) patients. Between 2013 and 2016, 23 pediatric hospitals from 17 countries provided data to the EuroPedHP-Registry on consecutive H. pylori-infected children. Of the 1333 patients included, 1168 were therapy naive (group A) and 165 had previously failed treatment (group B). Patients were from North/Western, Southern, and Eastern Europe, as well as Israel/Turkey. The most common reasons for an endoscopy were stomach discomfort or dyspepsia. Antral nodularity was observed in 77.8 percent of patients, while gastric or duodenal ulcers and erosions were detected in 5.1 percent and 12.8 percent of patients, respectively. Primary resistance to clarithromycin (CLA) and metronidazole (MET) occurred in 25% and 21% of patients, respectively, and increased after treatment failure. Bacterial strains were completely sensitive in 60.5 percent of Group A but just 27.4 percent of Group B. Southern and Eastern Europe had greater levels of primary CLA resistance than Northern and Western Europe. With 7 to 14 days triple therapy adjusted to antibiotic susceptibility, treatment effectiveness in group A was only 79.8 percent.

In dyspeptic H. pylori-infected children, peptic ulcers are uncommon. Primary resistance to CLA and MET is highly dependent on birth and residency areas. The current survey will determine if the new ESPGHAN/NASPGHAN recommendations will enhance eradication success.