pylori infection [25, 26]. They demonstrated that H. pylori inhibited LPS-induced maturation of dentritic cells and therefore failed to induce T-cell effectors functions in mice younger than 2 weeks. Recently, Zevit et al.[27] published the results of a large retrospective study, whereby H. pylori negative status was recognized as an independent risk factor

for pediatric asthma. This is the first study that used UBT and not serology to determine the H. pylori infection [27]. In addition, a study from Chile confirmed that H. pylori infection was less frequent in children with severe allergy [28]. According to the authors, increased levels of TGF-β found in H. pylori-infected children without allergy could be a plausible explanation linking chronic H. pylori positive gastritis with downregulated clinical expression of allergies Selleckchem Dasatinib [28]. Similarly, H. pylori-infected toddlers from Ethiopia were found with significantly lower risk of skin allergies

[29]. In contrast to these results, a large Dutch study [30] did not confirm any association between H. pylori seropositivity and wheezing (OR, 0.52; 95% CI, 0.25–1.06), allergic Doxorubicin rhinitis (OR, 0.96; 95% CI, 0.51–1.81), atopic dermatitis (OR, 1.05; 95% CI, 0.56–1.98) or physician-diagnosed asthma (OR, 0.87; 95% CI, 0.37–2.08). Therefore, based on currently available data, no conclusion on the association between H. pylori infection and reduced risk of allergies can be established. The updated evidence-based guidelines from the joint societies of ESPGHAN and NASPGHAN for H. pylori infection in children published in 2011, recommend eradication treatment in children with PUD and suggest to consider this treatment in some other situations Carbohydrate in H. pylori-infected children [13]. As a first-line therapy, the same guidelines proposed three different regimens: triple therapy with a PPI and amoxicillin and

imidazole or clarithromycin; or with a bismuth salts, amoxicillin and imidazole; or sequential therapy [13]. An important factor limiting treatment success is antibiotic resistance, which varies between countries, and therefore, surveillance of antibiotic resistance rate in different geographic areas is recommended. A recent multicenter report on the resistance of H. pylori over the period of 20 years in Belgium showed that primary metronidazole resistance in pediatric patients remained stable (23.4%), resistance rates to amoxicillin, tetracycline and ciprofloxacin were low or nonexistent, and that the clarithromycin resistance rate was the highest 10 years ago (16.9%) and decreased subsequently [31].