The effect of oral administration of Lactobacillus GG on antibiotic‐associated gastrointestinal side‐effects during Helicobacter pylori eradication therapy

Abstract

Background: One‐week triple therapy is currently considered the golden standard against Helicobacter pylori. However, gastrointestinal side‐effects are among the major pitfalls in such regimens. Probiotic supplementation might help to prevent or reduce such drug‐related manifestations. Aim: To determine whether adding the probiotic Lactobacillus GG to an anti‐H. pylori regimen could help to prevent or minimize the gastrointestinal side‐effects burden. Methods: Sixty healthy asymptomatic subjects screened positive for H. pylori infection were randomized to 1 week rabeprazole (20 mg b.d.), clarithromycin (500 mg b.d.), tinidazole (500 b.d.) and the probiotic Lactobacillus GG for 14 days or to the same regimen with a placebo preparation. Patients completed validated questionnaires during the week of treatment and during the following 3 weeks, to determine the type and severity of side‐effects and an overall judgement of tolerability. Results: Diarrhoea, nausea and taste disturbance were significantly reduced in the Lactobacillus GG supplemented group (relative risk=0.1, 95% CI: 0.1–0.9; relative risk=0.3, 95% CI: 0.1–0.9; relative risk=0.5, 95% CI: 0.2–0.9, respectively). An overall assessment of treatment tolerability showed a significant difference in favour of the Lactobacillus GG supplemented group (P=0.04). Conclusions: Lactobacillus GG supplementation showed a positive impact on H. pylori therapy‐related side‐effects and on overall treatment tolerability.

Effects of multispecies probiotic supplementation on intestinal microbiota in irritable bowel syndrome

“…In this multispecies probiotic L. rhamnosus GG, the most extensively studied probiotic strain worldwide, was combined with one Lactobacillus strain, one Propionibacterium strain and one Bifidobacterium strain. The advantageous effects of L. rhamnosus GG have been well documented in various GI disturbances, 24,25 but the strain alone has not been successful in IBS. 47 Recently, certain species of Bifidobacterium, Lactobacillus and Streptococcus were shown to provoke different effects on gut motility, 48 indicating that a combination of different species may give a broader effect on motility disturbances.…”

“…Lactobacillus rhamnosus GG (ATCC 53103) Prevention and treatment of various gastrointestinal disorders, especially diarrhoea, 24,25 immunomodulation in vitro 26 and in clinical studies 27,28 Lactobacillus rhamnosus Lc705 (DSM 7061)…”

Inulin and levan synthesis by probiotic Lactobacillus gasseri strains: characterization of three novel fructansucrase enzymes and their fructan products

“…L. gasseri is associated with a variety of probiotic functions including reduction of activities of faecal mutagenic enzymes (Pedrosa et al, 1995), adherence to intestinal tissues (Conway et al, 1987;Kirjavainen et al, 1998), stimulation of macrophages (Kirjavainen et al, 1999;Tejada-Simon & Pestka, 1999) and production of bacteriocins (Itoh et al, 1995). The probiotic role of several lactobacilli has been attributed to the synthesis of prebiotic fructose-based polysaccharides (fructans) from sucrose involving fructansucrase or fructosyltransferase (FTF) enzymes (Armuzzi et al, 2001;Korakli et al, 2002;Oda et al, 1983).…”

The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

“…However, it is difficult to attribute the failure of the treatment of AAD only to the quantity of probiotics offered, as, assessing some studies using probiotics to prevent AAD, there is much overlapping of doses among those that showed effectiveness and those that did not. In the majority of those that achieved positive effects, the daily doses were 2×10 8 to 4.4×10 10 CFU 20,25,[28][29][30] , whereas for investigations that obtained negative results, the doses used were 1×10 9 to 4×10 10 CFU 4,11,[23][24]31 .…”