Lactobacillus reuteri in the treatment of Helicobacter pylori infection

Dore, Maria Pina; Cuccu, Marianna; Pes, Giovanni Mario; Manca, Alessandra; Graham, David Y.

doi:10.1007/s11739-013-1013-z

Cited by 55 publications

(54 citation statements)

References 27 publications

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“…L . reuteri has also been used as an eradication agent per se, with pantoprazole in an open‐label study, but achieved a cure rate of only 14% by ITT analysis . Three meta‐analyses have been published on the role of probiotics as adjuvant treatments for H .…”

Section: Probioticsmentioning

confidence: 99%

Treatment of Helicobacter pylori Infection 2015

et al. 2015

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Many interesting articles have been published from many parts of the world over the last year assessing different issues around Helicobacter pylori eradication therapy. This article will address the published literature over the last year pertaining to the topic of treatment of H. pylori infection. The main themes that emerge are assessing the efficacy of standard triple therapy, as well as exploring new first-line treatments, mainly optimized nonbismuthand bismuth-containing quadruple therapies with some promising data also emerging on dual therapy. There was also considerable progress in investigating antibiotic resistance rates with much more data emerging from varied parts of the world compared to recent years. There have also been advances in the use of adjunctive therapies, especially probiotic therapies. Undoubtedly, the eradication of H. pylori remains a worthwhile goal to alleviate the burden of diseases caused by the complications of this infection, including dyspepsia, peptic ulcer disease, and gastric cancer. Triple TherapyA number of studies have been published this year, primarily from Asia, on standard triple therapy which remains the regimen recommended in the majority of published guidelines. A meta-analysis from China showed suboptimal eradication rates in this part of the world with a pooled rate of 74.5% which was inferior when compared to sequential therapy with relative risk (RR) = 0.863 [1]. Better, but still insufficient, eradication rates however were noted in Korea, with an overall eradication rate of 84% from 2005 to 2010 [2]. In Japan, while rates remain clearly suboptimal, eradication rates by per-protocol (PP) analysis have not changed between 2001 and 2010 although there has been a decline in eradication rates by intention-to-treat (ITT) analysis [3]. Another Japanese group from a region of higher clarithromycin resistance compared 7-day standard triple therapy with rabeprazole, amoxicillin, and clarithromycin (RAC) to rabeprazole, amoxicillin, and metronidazole (RAM). They found ITT eradication rates of 73% in the RAC group and 91% in the RAM group [4]. In other regions, a study in Nigeria found an eradication rate of 87% for triple therapy with no difference between 7 and 10 days of treatment [5]. An interesting study from Spain showed that when clarithromycin susceptibility testing is carried out prior to treatment, eradication rates reach 94% compared to 72% for empiric treatment, based on a 10-day regimen [6]. Similar findings emerged from a Japanese study where 97% eradication was achieved when antimicrobial susceptibility testing was carried out prior to treatment, and it was 95% eradication in a Korean study [7,8]. Another study from Spain examined the optimal first-line eradication regimen for patients with penicillin allergy and reported ITT eradication rates with omeprazole-clarithromycin-metronidazole of only 57% compared to 74% for PPI-bismuth-tetracyclinemetronidazole, with equivalent rates of compliance and adverse events. In this specific group for second-line treat...

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Section: Probioticsmentioning

confidence: 99%

Treatment of Helicobacter pylori Infection 2015

et al. 2015

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“…This also was reflected in two other trials from Iran and Brazil where multistrain probiotics as adjunct therapy failed to show a benefit for eradication . Another study examined the role of L. reuteri without antibiotic therapy, finding a cure rate of 13.6% (3/22) when it was used with PPI . Bifidobacterium infantis has also been proposed as having anti‐ H .…”

Section: Probioticsmentioning

confidence: 97%

Treatment of Helicobacter pylori Infection 2014

et al. 2014

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This review summarizes important studies regarding H.pylori therapy published from April 2013 to April 2014. The main themes that emerge are assessing the efficacy of standard triple therapy, as well as exploring new first-line treatments, predominantly optimized triple therapies and non-bismuth quadruple schemes. Regarding newer non-bismuth quadruple regimens, the compliance and tolerance seem to be similar for sequential and concomitant regimens. Notably, no study yet has demonstrated a clear statistical superiority for either, and a systematic review and meta-analysis may be warranted. Other studies examined the role of levofloxacin and bismuth based therapies in H. pylori eradication. The efficacy of bismuth as a second-line after sequential therapy was particularly noteworthy. Levofloxacin-based therapies also appear to be useful and versatile as part of different antibiotic combinations and in first-, second-, and third-line therapies. The emerging problem of quinolone resistance remains a worry. Individualized therapy, based on factors such as antimicrobial information, resistance data, and CYP2C19 metabolism, may well be the most notable future trend to emerge this year.

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“…Lactobacillus reuteri ( L. reuteri ) was found to have a positive effect on both H. pylori eradication and therapy‐related side effects . In a prospective, double‐blind, randomized, placebo‐controlled study, L. reuteri increased the eradication rate by 9.1% (from 65.9% to 75%) .…”

Section: Probiotics and H Pylori Eradication Therapymentioning

confidence: 99%

“…Lactobacillus reuteri (L. reuteri) was found to have a positive effect on both H. pylori eradication and therapy-related side effects. 51,52 In a prospective, double-blind, randomized, placebo-controlled study, L. reuteri increased the eradication rate by 9.1% (from 65.9% to 75%). 52 In levofloxacin-based second-line therapy, L. reuteri increased eradication rates (80% vs 62%, P < 0.05) and reduced the incidences of common therapy-related side effects in a single-center, prospective, randomized controlled study.…”

Section: Xy Zhu and F Liumentioning

confidence: 99%

Probiotics as an adjuvant treatment in Helicobacter pylori eradication therapy

Zhu

Liu

2017

J of Digest Diseases

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Over 80% of individuals infected with Helicobacter pylori (H. pylori) are asymptomatic. Increased resistance to antibiotics and decreased compliance to the therapeutic regimens have led to the failure of eradication therapy. Probiotics, with direct and indirect inhibitory effects on H. pylori in both animal models and clinical trials, have recently been used as a supplementary treatment in H. pylori eradication therapy. Probiotics have been considered useful because of the improvements in H. pylori eradication rates and therapy-related side effects although treatment outcomes using probiotics are controversial due to the heterogeneity of species, strains, doses and therapeutic duration of probiotics. Thus, despite the positive role of probiotics, several factors need to be further considered during their applications. Moreover, adverse events of probiotic use need to be noted. Further investigations into the safety of adjuvant probiotics to H. pylori eradication therapy are required.

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Lactobacillus reuteri in the treatment of Helicobacter pylori infection

Cited by 55 publications

References 27 publications

Treatment of Helicobacter pylori Infection 2015

Treatment of Helicobacter pylori Infection 2015

Treatment of Helicobacter pylori Infection 2014

Probiotics as an adjuvant treatment in Helicobacter pylori eradication therapy

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