Impact of Age, Gender, and Addition of Probiotics on Treatment Success for Helicobacter pylori in Children

Abstract

The primary objective of this study was to evaluate the effect of age, gender, and the use of probiotics with standard treatment regimen on Helicobacter pylori eradication. Based on endoscopic findings and clinical presentation, selected patients were treated with standard triple therapy (omeprazole, clarithromycin, and amoxicillin). Those who failed were offered a repeat treatment with omeprazole, metronidazole, and amoxicillin. After the publications of the possible advantages of probiotic treatment on H pylori eradication, the probiotic agent “Probiotica Forte” was routinely added to the treatment. Eradication was noted for 94/130 patients (72%) and for 128/197 patients (65%) with or without probiotic agent, respectively (P = .23). For second-line treatment eradication was noted in 33/46 (72%) and in 9/20 (45%) with or without probiotic agent, respectively (P = .053). The addition of probiotics may improve eradication success especially in addition to second-line treatment.

Clinical background factors affecting outcomes of Helicobacter pylori eradication therapy in primary care

“…A larger sample with more patients and physicians is needed for more accurate investigation. Second, the study could have assessed other factors that were previously reported to affect outcome of eradication therapy, such as smoking, alcohol use, and use of combined probiotics . These factors could not be controlled because we conducted a retrospective review of the patients’ medical records.…”

“…Second, the study could have assessed other factors that were previously reported to affect outcome of eradication therapy, such as smoking, alcohol use, and use of combined probiotics. [19][20][21]28 These factors could not be controlled because we conducted a retrospective review of the patients' medical records. Third, drug adherence was insufficiently assessed because we could not establish whether they had forgotten to take the drugs.…”

“…However, routine CAM sensitivity testing for all patients with H pylori infection would be difficult because of high clinical costs. Probiotic therapy is reported to improve the efficacy and tolerability of eradication therapy; however, this remains controversial . Drug adherence and smoking cessation guidance contribute to improvement in the H pylori eradication rate without increasing the cost .…”

Probiotics as an adjuvant treatment in Helicobacter pylori eradication therapy

“…The reason for these contradictory results may be due to the small number of studies with a subgroup analysis on children . Unlike the results found in adults, a probiotics compound can notably increase eradication rates in children in second‐line treatment (omeprazole, amoxicillin and metronidazole for 14 days; 72% vs 45%, P = 0.053) …”

Helicobacter pylori Infection in Pediatric Patients: Update on Diagnosis and Eradication Strategies

“…However, a recent meta-analysis including 10 randomized studies showed that in 318 of 409 (78%) children who received a sequential treatment, the infection was eradicated compared with 314 of 444 (70.7%) in the triple therapy arm (RR 1.14, 95% CI 1.06-1.23) [101]. Weiner and Shaoul [122] evaluated the efficacy of a triple therapy containing clarithromycin for 14 days as first-line treatment and containing metronidazole as rescue treatment. Antimicrobial susceptibility was not tested, and a comparison was made between those receiving the triple therapy alone and those receiving a probiotic.…”