SUMMARYBackground: The possibility of inducing oral desensitization in patients with food allergy is still controversial and no standardized programmes are yet available. Aim: To evaluate the safety and efficacy of oral desensitization in patients with allergy induced by the most common food allergens. Methods: Fifty-nine patients with food allergy underwent an oral desensitizing treatment according to standardized protocols. The control group consisted of age-and sex-matched subjects, who followed a strict elimination diet. Specific immunoglobulin E and immunoglobulin G 4 were assessed at baseline and after 6, 12 and 18 months.
SUMMARYBackground: Antibiotic-associated diarrhoea can be attributed in part to imbalances in intestinal microflora. Therefore, probiotic preparations are used to prevent this diarrhoea. However, although several trials have been conducted, no conclusive evidence has been found of the efficacy of different preparations, e.g. Lactobacillus spp. and Saccharomyces spp. Aim: To conduct a meta-analysis of the data in the literature on the efficacy of probiotics in the prevention of antibiotic-associated diarrhoea. Methods: A literature search was performed of electronic databases, Abstract Books and single paper references. Data were also obtained from the authors. Only placebo-
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.
The`rediscovery' of Helicobacter pylori and the recognized association between infection and a wide range of upper gastrointestinal illnesses has profoundly modi®ed the management and therapeutic approach towards most of these conditions. 1 At present, there are numerous treatment options for curing H. pylori infection and many still are under investigation.2 One-week triple therapy, combining acid suppression with two antibiotics, is currently regarded as the gold standard for anti-H. pylori treatment, 1 representing the best choice if criteria such as ef®cacy, tolerability, simplicity of administration, compliance and costs are considered.3±5 However, eradication rates in the community setting vary from roughly 65% to 80%, and inappropriate regimen prescription, poor patient compliance and, ®nally, primary and secondary bacterial resistance, are among factors which may contribute to treatment failure. 6 Moreover, antibiotic treatments are often associated with gastrointestinal side-effects such as diarrhoea, nausea, vomiting, bloating and abdominal pain. 7,8 Human Lactobacilli are the predominant bacteria found in the normal stomach of fasting subjects, although their density is small, ranging from 0 to 10 3 per mL of¯uid.
Background: One-week triple therapy is currently regarded as the reference of anti-Helicobacter pylori treatment. However, antibiotic-associated gastrointestinal side effects are among the major pitfalls of such regimens. Probiotic supplementation may be regarded as a therapeutic tool to prevent or reduce these troublesome drug-related manifestations. Aim: To determine whether the addition of the probiotic Lactobacillus GG to an anti-H. pylori standard triple therapy could help to prevent or minimize the occurrence of gastrointestinal side effects. Methods: One hundred and twenty healthy asymptomatic subjects screened positive for H. pylori infection and deciding to receive eradication therapy were randomized either to 1-week pantoprazole (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), tinidazole (500 mg b.i.d.) or to the same regimen supplemented with Lactobacillus GG for 14 days. Patients filled in validated questionnaires during follow-up to determine the type and severity of side effects and to judge overall tolerability. Results: Bloating, diarrhea and taste disturbances were the most frequent side effects during the eradication week and were significantly reduced in the Lactobacillus GG-supplemented group (RR = 0.4, CI 0.2–0.8; RR = 0.3, CI 0.1–0.8; RR = 0.3, CI 0.1–0.7, respectively). The same pattern was observed throughout the follow-up period. Overall assessment of treatment tolerability showed a significant trend in favor of the Lactobacillus GG-supplemented group (p = 0.03). Conclusions:Lactobacillus GG supplementation beneficially affects H. pylori therapy-related side effects and overall treatment tolerance.
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