Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis

Feng, Jianhua; Wang, Fan; Xiao, Qiu; McFarland, Lynne V.; Chen, Pengfei; Zhou, Rui; Liu, Jing; Zhao, Qiu; Li, Jin

doi:10.1007/s00228-017-2291-6

Cited by 91 publications

(63 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous meta-analyses on probioticsupplemented triple therapy for H. pylori infection in children showed that the efficacy and safety appeared to be different according to the different probiotics used. Feng et al 30 There was no significant difference between the groups in terms of eradication rate and symptom relief, so the synbiotic addition showed no superiority.…”

Section: Probiotics Prebiotics and Synbioticsmentioning

confidence: 95%

“…Previous meta‐analyses on probiotic‐supplemented triple therapy for H. pylori infection in children showed that the efficacy and safety appeared to be different according to the different probiotics used. Feng et al performed a systemic review and meta‐analysis aiming to identify which probiotic strain or regimen is more effective as a supplementation in H. pylori triple therapy for pediatric populations; 29 trials (3122 participants) involving 17 probiotic regimens were identified. Compared with a placebo, probiotics significantly increased H. pylori eradication rates (relative ratio [RR] 1.19, 95% CI 1.13‐1.25) and reduced the incidence of side effects (RR 0.49, 95% CI 0.38‐0.65).…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Helicobacter pyloriand some aspects of gut microbiota in children

2018

View full text Add to dashboard Cite

Helicobacter pylori infection in children differs from infection in adults in many aspects. The rate of infection, epidemiology, clinical presentations and complications, the applicability of diagnostic tests, antibiotic resistance, treatment options, and success rates differ significantly. Due to all these differences, management guidelines for children and adults differ also substantially. In 2017, the Updated ESPGHAN and NASPGHAN Guidelines on the management of H. pylori infection in children were published, emphasizing the differences in clinical presentation and indications for treatment, stating that the primary goal of clinical investigation in children is to identify the cause of upper gastrointestinal symptoms rather than the presence of H. pylori infection. Therefore, the diagnosis should be based on upper endoscopy, and the "test and treat strategy" should not be used in children. Due to an increasing rate of antibiotic resistance worldwide, the updated guidelines recommend broader use of antimicrobial susceptibility testing for H. pylori strains in order to tailor eradication treatment accordingly. Moreover, treatment in children should be prescribed only when indicated and should be based on the rate of eradication in local populations aiming for treatment success above 90%. During the last two decades there has been a steady decrease in the rate of H. pylori infection in both children and adults in the Western world. Two recent publications studying the incidence of H. pylori infection confirmed that early childhood is a time for acquisition of infection both in industrialized and nonindustrialized countries. In addition, they showed that H. pylori could be acquired outside the family. In respect to the inverse association between H. pylori and allergy, a longitudinal study demonstrated that early exposure to H. pylori at any age was inversely associated with atopy and allergic conditions.

show abstract

Section: Probiotics Prebiotics and Synbioticsmentioning

confidence: 95%

Section: Treatmentmentioning

confidence: 99%

Helicobacter pyloriand some aspects of gut microbiota in children

2018

View full text Add to dashboard Cite

show abstract

“…Another study suggested the combination of Bacillus mesentericus, Clostridium butyricum, and Streptococcus faecalis as the optimal probiotic regime for reducing side effects and improving eradication rates when supplementing 14‐day triple therapy . Current meta‐analyses suggest that probiotics as an adjunctive therapy increase the cure rate by approximately 10%‐14% . In addition, probiotics are likely to improve compliance and therefore improve eradication rates of triple therapy.…”

Section: Probioticsmentioning

confidence: 99%

“…68 Current meta-analyses suggest that probiotics as an adjunctive therapy increase the cure rate by approximately 10%-14%. [14][15][16][17] In addition, probiotics are likely to improve compliance and therefore improve eradication rates of triple therapy. However, the potential benefit of adding probiotics to more recent and effective combinations (such as concomitant or BQT regimens) has yet to be proven.…”

Section: Prob Iotic Smentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Helicobacter pylori infection in 2018

et al. 2018

View full text Add to dashboard Cite

Treatment options for the eradication of Helicobacter pylori continue to evolve. There have been many guidelines for H. pylori treatment published, which may lead to some confusion. However, most are in agreement with the most recent iteration of the Maastricht treatment guidelines. Triple therapy is still the most frequently used treatment, especially in areas of low clarithromycin resistance. Its best results are achieved when taken for a minimum of 10 days and with high-dose acid suppression. Quadruple therapy is gaining in popularity particularly in areas with increasing resistance to standard triple therapy. Whether three antibiotics, or bismuth and two antibiotics are used, excellent eradication rates are achieved, albeit with increased side effects. Levofloxacin second-line therapy is widely used; however bismuth, when available, is an increasingly successful option. Sequential therapy is challenging in terms of compliance and is no longer recommended. This past year witnessed a notable increase in the number of studies based on antimicrobial susceptibility testing and tailored eradication therapy, reflecting the role of culture-guided treatment, which may well represent the future of H. pylori treatment and prevent the inappropriate use of antibiotics.

show abstract

Probiotics in Disease Prevention and Treatment

Liu

Tran

Rhoads

2018

The Journal of Clinical Pharma

170

115

View full text Add to dashboard Cite

Few treatments for human diseases have received as much investigation in the past 20 years as probiotics. In 2017, English-language meta-analyses totaling 52 studies determined the effect of probiotics on conditions ranging from necrotizing enterocolitis and colic in infants to constipation, irritable bowel syndrome, and hepatic encephalopathy in adults. The strongest evidence in favor of probiotics lies in the prevention or treatment of 5 disorders: necrotizing enterocolitis, acute infectious diarrhea, acute respiratory tract infections, antibiotic-associated diarrhea, and infant colic. Probiotic mechanisms of action include the inhibition of bacterial adhesion; enhanced mucosal barrier function; modulation of the innate and adaptive immune systems (including induction of tolerogenic dendritic cells and regulatory T cells); secretion of bioactive metabolites; and regulation of the enteric and central nervous systems. Future research is needed to identify the optimal probiotic and dose for specific diseases, to address whether the addition of prebiotics (to form synbiotics) would enhance activity, and to determine if defined microbial communities would provide benefit exceeding that of single-species probiotics.

show abstract

Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis

Abstract: Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation.

Cited by 91 publications

References 35 publications

Helicobacter pyloriand some aspects of gut microbiota in children

Helicobacter pyloriand some aspects of gut microbiota in children

Treatment of Helicobacter pylori infection in 2018

Probiotics in Disease Prevention and Treatment

Contact Info

Product

Resources

About