Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy?

Abstract

Background:The standard triple therapy for the eradication of Helicobacter pylori consists of a combination of a proton pump inhibitor at a standard dose together with two antibiotics (amoxicillin 1000 mg plus either clarithromycin 500 mg or metronidazole 400 mg) all given twice daily for a period of 7-14 days. Recent reports have shown a dramatic decline in the rate of H. pylori eradication utilizing standard triple therapy from 95% down to 70-80%.Aims:Our study was designed to evaluate the effect of adding a probiotic as an adjuvant to common regimens used for H. pylori eradication.Materials and Methods:An open label randomized observational clinical study was designed to test three different regimens of H. pylori eradication treatment: Standard triple therapy with a concomitant probiotic added at the same time (n = 100), starting the probiotic for 2 weeks before initiating standard triple therapy along with the probiotic (n = 95), and the third regimen consists of the probiotic given concomitantly to sequential treatment (n = 76). The three arms were compared to a control group of patients treated with the traditional standard triple therapy (n = 106).Results:The eradication rate for the traditional standard therapy was 68.9%, and adding the probiotic “Bifidus infantis” to triple therapy, led to a successful rate of eradication of 83% (P < 0.001). Pre-treatment with 2 weeks of B. infantis before adding it to standard triple therapy increased the success rate of eradication to 90.5%. Similar improvement in eradication rate was noted when B. infantis was added as an adjuvant to the sequential therapy leading to an eradication rate of 90.8%.Conclusion:Adding B. infantis as an adjuvant to several therapeutic regimens commonly used for the eradication of H. pylori infection significantly improves the cure rates.

The Effect of Probiotics Supplementation on Helicobacter pylori Eradication Rates and Side Effects during Eradication Therapy: A Meta-Analysis

“…Nine studies enrolled only children [24]–[26], [33], [34], [36], [44], [45], [49] and 24 were undertaken exclusively with adults [17]–[23], [27]–[32], [35], [37]–[43], [46]–[48]. From all the included trials, 29 used PPI-triple therapy [17]–[25], [27]–[29], [31]–[41], [43]–[46], [48], [49], three used sequential therapy [26], [30], [42] and one used bismuth-quadruple therapy [47]. These studies were undertaken in Argentina [25], Brazil [46], mainland China [41], [49], China (Taiwan) [21], Finland [23], France [38], Iran [43], [45], [47], Italy [17]–[20], [22], [26], [29], [30], [32], [42], [44], Japan [40], Korea [31], [35], Poland [27], [34], Romania [33], Turkey [28], [36], [37], [39], United Kingdom [24] and the U...…”

Probiotics inHelicobacter pylorieradication therapy: A systematic review and meta-analysis

“…Ahmad et al [40] , 2013 66 Children RUT/HA HpSA Lacto + Bifido + Strep 3000A + 360F + 60M Shavakhi et al [41] ,2013 180 Adults RUT/HA UBT Lacto + Bifido + Strep 2000A + 480B + 1000C + 40M Kyriakos et al [42] , 2013 70 Adults RUT + HA UBT Saccha 2000A + 1000C + 40M Jiang et al [43] , 2013 2 80 Adults RUT + Giemsa UBT Bacillus 2000A + 60La + 3000Le Dajani et al [44] , 2013 2 301 Both UBT/RUT/HA/ HpSA…”

Friend and foe: factors influencing the movement of the bacterium Helicobacter pylori along the parasitism–mutualism continuum

“…; Dajani et al. ). The decreasing efficacy of antibiotic therapy makes it unrealistic to expect success with population‐wide eradication.…”