Clinical Outcomes of Standard Triple Therapy Plus Probiotics or Concomitant Therapy for Helicobacter pylori Infection

Abstract

Background/AimsThe efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection.MethodsWe reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week.ResultsThe intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002).ConclusionsSTP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.

Treatment of Helicobacter pylori infection in 2018

“…As the effective treatment duration increases, there is a concern regarding antimicrobial side effects. In one recent study, the addition of a probiotic was shown to reduce the frequency of adverse events from 28.2% in the nonprobiotic group to 12.2% …”

“…In one recent study, the addition of a probiotic was shown to reduce the frequency of adverse events from 28.2% in the nonprobiotic group to 12.2%. 65 A meta-analysis reported that the addition of a probiotic to bismuth-based quadruple therapy increases the eradication rate by approximately 10%. 14 A systematic review assessed the efficacy of probiotics as monotherapy.…”

Probiotics, their prophylactic and therapeutic applications in human health development: A review of the literature

“…The gram-negative, flagellated bacteria Helicobacter pylori is typically found on the luminal surface of the stomach epithelium. Because of severe side effects and changes in natural flora, the efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has declined [ 64 ]. Probiotics improve immune-regulation functions, which operate as an antidote to Helicobacter pylori infection, and hence inhibit Helicobacter pylori infection.…”

Current and Future Treatment of Helicobacter pylori Infections

“…14 of this book. For example, one recent study reported that the addition of a probiotic reduced the frequency of adverse events from 28.2% to 12.2% (Jung et al 2018). Oh and co-workers (2016) analyzed the microbiome of patients receiving probiotics compared to those receiving antimicrobial eradication therapy alone and found that although the microbiota were similar, as assessed by metagenomes sequencing, there was a greater proportional shift in functional gene families in those receiving antibiotics compared to those receiving the probiotic (Medilac-S ® ; Streptococcus faecium 9 × 10 8 and Bacillus subtilis 1 × 10 8 ).…”