Role of Probiotics in Pediatric Patients with Helicobacter pylori Infection: A Comprehensive Review of the Literature

Abstract

Background: The current guidelines suggest the use of triple therapy as first choice treatment of Helicobacter pylori infection, although the eradication failure rate is more than 30%. Current interest in probiotics as therapeutic agents against H. pylori is stimulated not only by the clinical data showing efficacy of some probiotics in different gastrointestinal diseases but also by the increasing resistance of pathogenic bacteria to antibiotics, thus the interest for alternative therapies is a real actual topic. Aim: To review in vitro and in vivo studies on the role of probiotics in H. pylori infection focusing on the paediatric literature. Materials and methods: Pre‐clinical and clinical paediatric studies in English assessing the role of probiotics in H. pylori infection identified by MEDLINE search (1950–2009) were reviewed. Results: In vitro studies demonstrated an inhibitory activity of probiotics on H. pylori growth and that this effect is extremely strain specific. Available data in children indicate that probiotics seems to be efficacious for the prevention of antibiotic associated side‐effects, and might be of help for the prevention of H. pylori complications by decreasing H. pylori density and gastritis, and for the prevention of H. pylori colonization or re‐infection by inhibiting adhesion to gastric epithelial cells. There is no clear evidence that probiotics may increase the H. pylori eradication rate. Conclusion: Both in vitro and in vivo studies provide evidence that probiotics may represent a novel approach to the management of H. pylori infection.

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

“…While the effectiveness of probiotic supplementation in increasing eradication rates has been more consistently reported in clinical studies as well as meta-analyses (16,17,(22)(23)(24)(25)(26)(27)(28)(29)(30), there is inconsistency regarding side effects, with demonstration of benefit in terms of overall side effects in probiotics groups in some studies (26,27,30), but a lack of any significant change in others (16,22,23,25,28,29,35,36).…”

“…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.…”

“…Owing to the growing need for newer alternative eradication regimens or adjuvant treatments, the addition of probiotics (administration of live microbial species) has been considered likely to offer beneficial health effects (15) and thus has attracted substantial interest with respect to H. pylori eradication therapy (16)(17)(18)(19). 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).…”

Probiotic Mechanism of Lactobacillus gasseri OLL2716 Strain against Helicobacter pylori

“…controversial, but there is more evidence supporting the role of probiotics in reducing the frequency of side effects caused by the triple-therapy regimen (7). Lactobacillus gasseri OLL2716 proved effective in both suppressing H. pylori colonization of the stomach and reducing gastric mucosal inflammation (8).…”

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

“…Several specific probiotics have been shown to lower H. pylori bacterial load and gastric inflammation and reduce antibiotic-associated side effects [8]. Our study focused on a single probiotic microorganism, i.e., Lactobacillus GG, to evaluate the probable effects of Lactobacillus GG given concomitantly with standard eradication therapy on major clinical outcomes related to H. pylori eradication and therapy-associated side effects.…”