To assess the efficacy of eradication of Helicobacter pylori infection in children living in Chengdu, China and identify the risk factors for treatment failure.

A retrospective analysis was performed on the clinical records of children who were diagnosed with Helicobacter pylori infection by breath urea test and gastroscopy, including demographic data, eradication therapy, and possible risk factors for treatment failure.

A total of 974 children with Helicobacter pylori infection who received the eradication therapy (514 males and 460 females) were involved, including 402 children under the age of 6 years and 572 children 6 years older. The total success rate of eradication was 69.82% (680/974), and the first time success rate was 64.99% (633/974); 116 children received twice and more times of eradication with a success rate of 40.52% (47/117). Approximately 72.00% (18/25) of children with peptic ulcer had successful eradication. A total of 1135 episodes of eradication treatment were completed, and the total success rate was 59.91% (680/1135). Metronidazole based triple regimen was the first choice of eradication between 2012 and 2015, with a success rate of 63.49%. However, the success rate increased to 73.83% after more applying the clarithromycin based triple regimen as the first-line therapy (χ²=11.72, P=0.001). Family member with Helicobacter pylori infection was the main risk factor affecting the outcome of treatment (odds ratio=3.921, 95%CI: 1.249-12.305, P=0.019).

The total success rate of Helicobacter pylori eradication therapy is under 80%. Using clarithromycin based triple regimen as the first-line therapy could increase the possibility of successful eradication; family member with Helicobacter pylori infection is the main environment factor impacting the results.