Lactobacillus plantarum associated with antimicrobial therapy in the eradication of Helicobacter pylori: a randomized clinical trial

Abstract

Background: Helicobacter pylori infection affects nearly 50% of the world's population, and 1 to 3% of patients infected with H. pylori have a risk of developing gastric cancer. Probiotics can inhibit the proliferation and adhesion of H. pylori. This study aimed to test Lactobacillus plantarum as an adjuvant therapy in treating H. pylori. Methods: Dyspeptic patients (18-74 years) with gastric infection documented and untreated were randomized into two groups: probiotic group (amoxicillin and clarithromycin for one week, esomeprazole for three weeks and Lactobacillus plantarum 5 x 108 CFU for four weeks) and placebo group (amoxicillin, clarithromycin, and esomeprazole for the same period). Four weeks after therapy, a re-endoscopy was performed. Results: Fifty patients were randomized, and 47 (mean 42.7 SD 14.8 years) concluded the study. The total eradication rate was 78.7% (p = 0.73). Further analyses by age group showed that in patients up to 45 years, the eradication rate in patients who received probiotics was 93.8% against 70.0% in the placebo group (p = 0.046). Conclusion: The results indicate the potential of using probiotics as an adjuvant in eliminating H. pylori, and the greater potential of probiotics use in younger age groups.