<i>Lactobacillus</i> GG Supplementation on Anti-<i>Helicobacter pylori</i> Therapy-Related Side Effects and Eradication Rates: A Meta-Analysis

Abstract

Background: Concerns still exist with respect to unsatisfactory eradication rates and/or therapyassociated side effects for the use of standard triple therapy in the treatment of Helicobacter pylori infection, which prompts considerable interest in new therapy. We systematically reviewed the literature to investigate whether Lactobacillus GG as supplementation to standard triple therapy could improve H. pylori eradication rates and/or reduce therapy-associated side effects. Methods: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) were systematically searched from their inception to August 4, 2015 for randomized controlled trials (RCTs). The language was restricted to English only. Results: Four RCTs involving a total of 305 participants (including 83 children) were included. Lactobacillus GG given along with triple therapy significantly reduced the risk of overall H. pylori therapy-related adverse effects (three RCTs, n = 221, RR 0.59, 95% CI 0.45 -0.78), particularly of diarrhea (four RCTs, n = 285, RR 0.23, 95% CI 0.11 -0.47), bloating (four RCTs, n = 289, RR 0.61, 95% CI 0.41 -0.90), and taste disturbance (four RCTs, n = 288, RR 0.38, 95% CI 0.23 -0.62). There were no significant differences between groups in the risk of other adverse effects. No beneficial effects of Lactobacillus GG were observed for H. pylori eradication rates (four RCTs, n = 284, RR 0.99, 95% CI 0.88 -1.13). Conclusion: Current evidence indicates that Lactobacillus GG administered along with standard triple therapy is a feasible way to reduce therapy-related side effects, particularly diarrhea, bloating, and taste disturbance. However, Lactobacillus GG shows no effects on eradication rates.

Antimicrobial Efficacy of Five Probiotic Strains Against Helicobacter pylori

“…Given this clear evidence, integration of probiotic strains before and during antibiotic therapy should increase the eradication rates and decrease the onset of dysbiosis-induced adverse events. Although the Maastricht Consensus states that "probiotics associated with antibiotic therapy have positive effects on the management of H. pylori infection" [19], meta-analyses of clinical trials published in this field give discrepant results, clearly supporting the need for further research in this area [20][21][22][23]. It is not possible to compare published clinical trials because of the extreme variability in terms of probiotic formulations used (type and duration of integration) and antibiotic therapies administered.…”