Twice‐a‐day PPI, tetracycline, metronidazole quadruple therapy with Pylera® or Lactobacillus reuteri for treatment naïve or for retreatment of Helicobacter pylori. Two randomized pilot studies

Dore, Maria Pina; Bibbò, Stefano; Loria, Mariafrancesca; Salis, Roberta; Manca, Alessandra; Graham, David Y.

doi:10.1111/hel.12659

Cited by 21 publications

(22 citation statements)

References 33 publications

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“…Bismuth intake may lead to abdominal discomfort by decreasing peristalsis and bowel frequency, because it shows antidiarrheal effects by decreasing the fluid and electrolytes flowing into the intestines . A comparison study between the bismuth‐containing quadruple therapy and Lactobacilli reuteri ‐containing quadruple therapy suggested replacement of bismuth with probiotics; however, patient compliance, efficacy, and drug safety were not different between the two groups …”

Section: Discussionmentioning

confidence: 99%

“…21 A comparison study between the bismuth-containing quadruple therapy and Lactobacilli reuteri-containing quadruple therapy suggested replacement of bismuth with probiotics; however, patient compliance, efficacy, and drug safety were not different between the two groups. 22 There are limitations to this study. First, this is not a prospective study.…”

Section: Ta B L Ementioning

confidence: 90%

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Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

et al. 2020

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Background/Aims Conventional second‐line, bismuth‐containing quadruple therapy is administered four times a day. We aimed to evaluate the efficacy and safety of twice a day administration compared to the four times a day therapy. Methods Medical records of consecutive patients with positive 13C‐urea breath tests (UBTs) after first‐line eradication were reviewed. From December 2018 to June 2019, 100 consecutive 13C‐UBT‐positive patients received tetracycline 1 g, metronidazole 750 mg, bismuth subcitrate 300 mg, and pantoprazole 20 mg twice a day for one week. The same number of consecutive13C‐UBT‐positive patients before December 2018 was included as controls. The control group received tetracycline 500 mg and bismuth subcitrate 300 mg four times a day, metronidazole 500 mg three times a day, and pantoprazole 20 mg twice a day for one week. Eradication was confirmed based on a 13C‐UBT performed in the 5th week after taking quadruple therapy. Results Ninety‐eight patients from the twice a day group and 99 patients from the four times a day group were analyzed. The eradication rate did not differ between the twice a day group (92/98, 93.9%) and the four times a day group (92/99, 92.9%). Adverse drug effects were found in 36 patients from the twice a day group and 50 patients from the four times a day group (P = .051). Abdominal pain, discomfort, and distention were more common with four times a day intake (13.1%) than with twice a day intake (4.1%; P = .024). Conclusions We determined for the first time that twice a day intake of bismuth‐containing quadruple therapy using 2 g/d of tetracycline, 1.5 g/d of metronidazole, and 600 mg/d of bismuth subcitrate for one week is effective and safe as the conventional four times a day therapy. Twice a day intake decreased abdominal pain, discomfort, and distention.

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Section: Discussionmentioning

confidence: 99%

Section: Ta B L Ementioning

confidence: 90%

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

et al. 2020

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“…The eradication rate was 100% in the bismuth-containing regimen against 90% in the probiotic group. The authors concluded that Gastrus ® might be considered when using bismuth is contraindicated or unavailable [ 37 ].…”

Section: Use Of L Reuteri 17938 (Or Mother Strain Atcc 55730) Against Hp Infection Without Antibioticsmentioning

confidence: 99%

Limosilactobacillus reuteri Strains as Adjuvants in the Management of Helicobacter pylori Infection

Dargenio

Bizzoco

et al. 2021

Medicina

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Helicobacter pylori (HP) is a Gram-negative bacterium which finds its suitable habitat in the stomach. The infection affects about half of the global population with high variability in prevalence among regions and for age. HP is the main causative agent of chronic active gastritis, peptic and duodenal ulcers, and may be the primary cause of gastric cancer or MALT lymphoma. Due to the high rate of failure of eradication therapy in various countries and the increase in antibiotic resistance reported in the literature, there is an ever wider need to seek alternative therapeutic treatments. Probiotics seem to be a promising solution. In particular, the Limosilactobacillus reuteri (L. reuteri) species is a Gram-positive bacterium and is commonly found in the microbiota of mammals. L. reuteri is able to survive the gastric acid environment and bile and to colonize the gastric mucosa. This species is able to inhibit the growth of several pathogenic bacteria through different mechanisms, keeping the homeostasis of the microbiota. In particular, it is able to secrete reuterin and reutericycline, substances that exhibit antimicrobial properties, among other molecules. Through the secretion of these and the formation of the biofilm, it has been found to strongly inhibit the growth of HP and, at higher concentrations, to kill it. Moreover, it reduces the expression of HP virulence factors. In clinical trials, L. reuteri has been shown to decrease HP load when used as a single treatment, but has not achieved statistical significance in curing infected patients. As an adjuvant of standard regimens with antibiotics and pump inhibitors, L. reuteri can be used not only to improve cure rates, but especially to decrease gastrointestinal symptoms, which are a common cause of lack of compliance and interruption of therapy, leading to new antibiotic resistance.

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“…Moreover, L. Reuteri produces antimicrobial molecules and promotes the development and the functionality of regulatory T cells, strengthening the gut barrier, and decreasing the microbial translocation from the intestinal lumen to the tissue, as reported by studies conducted on animal models [ 7 ], on humans [ 8 ] and in vitro [ 9 ]. Literature preclinical studies [ 10 ], using genetic tools such as genome sequencing, molecular tools, and genomic-based approaches (both in mice and then in humans) showed that L. reuteri has multiple beneficial effects on gastrointestinal symptoms, on gut infections, HP eradication, antibiotic-associated diarrhea, inflammatory bowel syndrome (IBS), inflammatory bowel disease (IBD), and colorectal cancer [ 11 , 12 , 13 ]. It can reduce abdominal pain in infantile colic, the functional abdominal discomfort in children, and it can decrease crying due to necrotizing enterocolitis in preterm neonates [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

et al. 2021

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Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

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Twice‐a‐day PPI, tetracycline, metronidazole quadruple therapy with Pylera® or Lactobacillus reuteri for treatment naïve or for retreatment of Helicobacter pylori. Two randomized pilot studies

Cited by 21 publications

References 33 publications

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

Limosilactobacillus reuteri Strains as Adjuvants in the Management of Helicobacter pylori Infection

Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

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