Effect of different probiotic preparations on anti-Helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study

Cremonini, Filippo; Di, Simona; Covino, Marcello; Armuzzi, Alessandro; Gabrielli, Maurizio; Santarelli, Luca; Nista, E.C.; Cammarota, Giovanni; Gasbarrini, Giovanni; Gasbarrini, Antonio

doi:10.1111/j.1572-0241.2002.07063.x

Cited by 290 publications

(173 citation statements)

References 18 publications

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“…Four of these studies found a statistically significant reduction in the incidence of AAD with LGG use in comparison to placebo [19,20,21,22]. One study found a significant decrease in the number of days of diarrhoea in the LGG group compared to placebo [18].…”

Section: Resultsmentioning

confidence: 99%

Is Lactobacillus rhamnosus GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

Hawrelak¹,

Whitten²,

Myers³

2005

Digestion

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Objective: To evaluate the efficacy of Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea. Data Sources: A computer-based search of MEDLINE, CINAHL, AMED, the Cochrane Controlled Trials Register and the Cochrane Database of Systematic Reviews was conducted. A hand-search of the bibliographies of relevant papers and previous meta-analyses was undertaken. Review Methods: Trials were included in the review if they compared the effects of L. rhamnosus GG and placebo and listed diarrhoea as a primary end-point. Studies were excluded if they were not placebo-controlled or utilised other probiotic strains. Results: Six trials were found that met all eligibility requirements. Significant statistical heterogeneity of the trials precluded meta-analysis. Four of the six trials found a significant reduction in the risk of antibiotic-associated diarrhoea with co-administration of Lactobacillus GG. One of the trials found a reduced number of days with antibiotic-induced diarrhoea with Lactobacillus GG administration, whilst the final trial found no benefit of Lactobacillus GG supplementation. Conclusion: Additional research is needed to further clarify the effectiveness of Lactobacillus GG in the prevention of antibiotic-associated diarrhoea.

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Section: Resultsmentioning

confidence: 99%

Is Lactobacillus rhamnosus GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

Hawrelak¹,

Whitten²,

Myers³

2005

Digestion

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“…Figure 2 shows the results of the methodological quality assessment. The allocation concealment was unclear in one RCT [17], and another trial [15] was at high risk of binding. The remaining two trials had good methodological quality.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Three RCTs were placebo controlled [16]- [18], and there was no additional intervention in the control group in the other one trial [15]. The included studies were conducted in Italy (three RCTs) [15]- [17] and Egypt (one RCT) [18]. Figure 2 shows the results of the methodological quality assessment.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In all four included trials, Lactobacillus GG was given along with standard triple therapy composed of a proton pump inhibitor and two antibiotics. The daily doses of Lactobacillus GG ranged from 1 × 10 9 CFU (b.i.d) [18] to 6 × 10 9 CFU (b.i.d) [15]- [17]. Three RCTs were placebo controlled [16]- [18], and there was no additional intervention in the control group in the other one trial [15].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The main characteristics of included trials are summarized in Table 2. Three studies enrolled only adults [15]- [17], and one RCT [18] (n = 83) was undertaken exclusively in children (age range: 5 -17 years). In all four included trials, Lactobacillus GG was given along with standard triple therapy composed of a proton pump inhibitor and two antibiotics.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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

Shakya¹,

Zhang²,

Hu³

et al. 2015

OJIM

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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.

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Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

Hempel

Newberry

Maher

et al. 2012

JAMA

691

146

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Context Probiotics are live microorganisms intended to confer a health benefit when consumed. One condition for which probiotics have been advocated is the diarrhea that is a common adverse effect of antibiotic use. Objective To evaluate the evidence for probiotic use in the prevention and treatment of antibiotic-associated diarrhea (AAD). Data Sources Twelve electronic databases were searched (DARE, Cochrane Library of Systematic Reviews, CENTRAL, PubMed, EMBASE, CINAHL, AMED, MANTIS, TOXLINE, ToxFILE, NTIS, and AGRICOLA) and references of included studies and reviews were screened from database inception to February 2012, without language restriction. Study Selection Two independent reviewers identified parallel randomized controlled trials (RCTs) of probiotics (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus) for the prevention or treatment of AAD. Data Extraction Two independent reviewers extracted the data and assessed trial quality. Results A total of 82 RCTs met inclusion criteria. The majority used Lactobacillusbased interventions alone or in combination with other genera; strains were poorly documented. The pooled relative risk in a DerSimonian-Laird random-effects metaanalysis of 63 RCTs, which included 11 811 participants, indicated a statistically significant association of probiotic administration with reduction in AAD (relative risk, 0.58; 95% CI, 0.50 to 0.68; PϽ.001; I 2 , 54%; [risk difference, −0.07; 95% CI, −0.10 to −0.05], [number needed to treat, 13; 95% CI, 10.3 to 19.1]) in trials reporting on the number of patients with AAD. This result was relatively insensitive to numerous subgroup analyses. However, there exists significant heterogeneity in pooled results and the evidence is insufficient to determine whether this association varies systematically by population, antibiotic characteristic, or probiotic preparation. Conclusions The pooled evidence suggests that probiotics are associated with a reduction in AAD. More research is needed to determine which probiotics are associated with the greatest efficacy and for which patients receiving which specific antibiotics.

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Effect of different probiotic preparations on anti-Helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study

Cited by 290 publications

References 18 publications

Is <i>Lactobacillus rhamnosus</i> GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

Is <i>Lactobacillus rhamnosus</i> GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

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

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

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Effect of different probiotic preparations on anti-Helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study

Cited by 290 publications

References 18 publications

Is <i>Lactobacillus rhamnosus</i> GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

Is <i>Lactobacillus rhamnosus</i> GG Effective in Preventing the Onset of Antibiotic-Associated Diarrhoea: A Systematic Review

&lt;i&gt;Lactobacillus&lt;/i&gt; GG Supplementation on Anti-&lt;i&gt;Helicobacter pylori&lt;/i&gt; Therapy-Related Side Effects and Eradication Rates: A Meta-Analysis

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

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