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No advantage for antibiotic treatment over placebo in Blastocystis hominis-positive children with recurrent abdominal pain


Heyland, Klaas; Friedt, Michael; Buehr, Patrick; Braegger, Christian P (2012). No advantage for antibiotic treatment over placebo in Blastocystis hominis-positive children with recurrent abdominal pain. Journal of Pediatric Gastroenterology and Nutrition, 54(5):677-679.

Abstract

OBJECTIVE: The aim of the study was to investigate whether recurrent abdominal pain (RAP) in Blastocystis hominis-positive children can be treated successfully with trimethoprim-sulfamethoxazole (TMP/SMX).
METHODS: From October 2004 to December 2008, all of the patients referred to the Division of Gastroenterology and Nutrition of the University Children's Hospital Zurich because of RAP and detection of B hominis in stool samples as the only pathological finding after a standard workup were offered to participate in the study. Patients were randomly assigned into 2 groups. TMP/SMX or placebo was given for 7 days in a double-blind, placebo-controlled manner. Pain index (PI) was measured with a visual analogue scale. Two weeks after completion of treatment, 3 stool samples were collected and patients were followed clinically. If B hominis was still present, metronidazole was given for 7 days.
RESULTS: Forty patients were included; 37 finished the study (TMP/SMX n = 20, placebo n = 17). Mean PI declined from 7.1 to 3.6 for all of the patients, with a decrease from 6.9 to 4.1 in the TMP/SMX and 7.4 to 3.0 in the placebo group, irrespective of detection of B hominis after treatment. There was no statistically significant difference in PI reduction between the 2 groups. Metronidazole treatment led to a further PI decline from 3.7 to 1.9. Eradication rates were 35% (TMP/SMX) and 44% (metronidazole), compared with spontaneous clearance of 29% in the placebo group.
CONCLUSIONS: There is no advantage for TPM/SMX over placebo in the treatment of RAP in B hominis-positive children.

Abstract

OBJECTIVE: The aim of the study was to investigate whether recurrent abdominal pain (RAP) in Blastocystis hominis-positive children can be treated successfully with trimethoprim-sulfamethoxazole (TMP/SMX).
METHODS: From October 2004 to December 2008, all of the patients referred to the Division of Gastroenterology and Nutrition of the University Children's Hospital Zurich because of RAP and detection of B hominis in stool samples as the only pathological finding after a standard workup were offered to participate in the study. Patients were randomly assigned into 2 groups. TMP/SMX or placebo was given for 7 days in a double-blind, placebo-controlled manner. Pain index (PI) was measured with a visual analogue scale. Two weeks after completion of treatment, 3 stool samples were collected and patients were followed clinically. If B hominis was still present, metronidazole was given for 7 days.
RESULTS: Forty patients were included; 37 finished the study (TMP/SMX n = 20, placebo n = 17). Mean PI declined from 7.1 to 3.6 for all of the patients, with a decrease from 6.9 to 4.1 in the TMP/SMX and 7.4 to 3.0 in the placebo group, irrespective of detection of B hominis after treatment. There was no statistically significant difference in PI reduction between the 2 groups. Metronidazole treatment led to a further PI decline from 3.7 to 1.9. Eradication rates were 35% (TMP/SMX) and 44% (metronidazole), compared with spontaneous clearance of 29% in the placebo group.
CONCLUSIONS: There is no advantage for TPM/SMX over placebo in the treatment of RAP in B hominis-positive children.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:19 Feb 2013 09:00
Last Modified:05 Apr 2016 16:29
Publisher:Lippincott, Williams & Wilkins
ISSN:0277-2116
Publisher DOI:https://doi.org/10.1097/MPG.0b013e31823a29a7
PubMed ID:22002479

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