Lactobacillus -containing probiotic supplementation increases Helicobacter pylori eradication rate: evidence from a meta-analysis

Abstract

Background: Helicobacter pylori infection is recognized as a major contributory factor to many diseases, but recommended eradication therapies demonstrated unsatisfactory eradication rates. Currently, some studies suggested that lactobacillus species have an inhibitory action on Helicobacter pylori both in vitro and in vivo.Objective: this meta-analysis broadly examined the efficacy of eradication regimens supplemented with lactobacillus-containing probiotic on eradication rates and side effects.Methods: eligible articles were identified by comprehensive searches. Statistical analysis was performed with Review Manager 5.2. Outcomes were finally evaluated according to GRADE system.Results: nine randomized controlled trials of high-quality met eligible criteria. Risk ratio of eradication was available for 1,163 patients. Lactobacillus-containing probiotics significantly increased the eradication rate compared with the control group based upon intention-to-treat analysis [RR = 1.14; 95 %CI (1.06-1.22); number needed to treat (NNT) = 10] by the fixed effect model without significant publication bias, but no significant reduction associated with overall side effects was observed [RR = 0.88;]. In the subgroup analysis, eradication rates raised significantly by 17 % in lactobacillus administrated alone group [RR = 1.25; 95 %CI (1.13-1.37); NNT = 6]. In multistrain probiotics group, eradication rates enhanced only 2.8 % [RR = 1.04; 95 %CI (0.94-1.14)]. It also showed that lactobacillus-containing probiotics improved the eradication rates, respectively, both in adults [RR = 1.12; Conclusions: Lactobacillus-containing probiotic as an adjunct is effective to eradication therapy, while side effects caused by eradication treatment may not decrease. Furthermore, lactobacillus administrated alone will distinctly benefit eradication therapy.

Improved Eradication Rate of Standard Triple Therapy by Adding Bismuth and Probiotic Supplement for Helicobacter pylori Treatment in Thailand

“…Several studies showed that an administration of bismuth in quadruple therapy increased the eradication rate of H. pylori to approximately 90%, significantly better than of standard triple therapy (Ford et al, 2008, Fock et al, 2009). In addition, recent studies have demonstrated that adding probiotic supplement to standard triple therapy significantly enhanced the H. pylori eradication rate (Mirzaee and Rezahosseini, 2012, Zheng et al, 2013, Wang and Huang, 2014. Thus far, the efficacy of H. pylori eradication by adding bismuth and probiotic to standard triple therapy has not been reported.…”

“…The CYP2C19 genotype testing was performed according to previously described technique (Zheng et al, 2013), and the results were expressed as: rapid metabolizer (RM), intermediate metabolizer (IM) or poor metabolizer (PM). The presence of H. pylori was defined as: 1) positive H. pylori culture, or (2) two positive tests (rapid urease test and histology).…”

“…Interestingly, recent studies have demonstrated the positive effect of adding probiotic (eg. Lactobacillus acidophilus and Bifidobacterium bifidum) to standard triple therapy for H. pylori eradication (Mirzaee and Rezahosseini, 2012, Zheng et al, 2013, Wang and Huang, 2014.…”

Use of probiotics as an adjuvant to sequential H. pylori eradication therapy: impact on eradication rates, treatment resistance, treatment-related side effects, and patient compliance

“…On the basis of the demonstration of anti-H. pylori activity of probiotics such as Lactobacillus, Saccharomyces boulardii, and Bifidobacterium, in in vitro and experimental models of H. pylori infection (19), probiotics have been suggested to improve H. pylori eradication and reduce side effects during therapy (17,20,21). However, findings from clinical studies on the use of probiotics as an adjuvant therapy to H. pylori infection have been inconsistent, with the demonstration of reduced side effects of antibiotics and improved eradication rates in some studies (16,(22)(23)(24)(25)(26)(27)(28)(29)(30), while no significant effects of adjuvant probiotics on eradication rates (22,(31)(32)(33)(34)(35)(36) or side effects (26,27,30,31,32,33,(35)(36)(37) have been reported in other studies.…”

The Role of Probiotics in the Treatment of Helicobacter Pylori Associated Diseases

“…Были опубликованы 11 метаанализов по оценке эффективности пробиотиков в качестве вспомогательных веществ для антибиотиков для эрадикации Нр [31][32][33][34][35][36][37][38][39][40][41][42]. Все исследования обнаружили, что добавление пробио-тика в схемы антибиотикотерапии увеличивает эффек-тивность лечения с отношением шансов в пределах от 1,12 до 2,07.…”