The Effects of Multistrain Probiotic Compound on Bismuth‐Containing Quadruple Therapy for Helicobacter pylori Infection: A Randomized Placebo‐Controlled Triple‐Blind Study

Abstract

In overall, our studied multistrain probiotic compound has not beneficial effects in the treatment of H. pylori infection. It might be related to the low dosage of our probiotic regimen and/or high frequency of upper gastrointestinal adverse effects which in turn could decrease the eradication efficacy.

Use of probiotics as an adjuvant to sequential H. pylori eradication therapy: impact on eradication rates, treatment resistance, treatment-related side effects, and patient compliance

“…While the effectiveness of probiotic supplementation in increasing eradication rates has been more consistently reported in clinical studies as well as meta-analyses (16,17,(22)(23)(24)(25)(26)(27)(28)(29)(30), there is inconsistency regarding side effects, with demonstration of benefit in terms of overall side effects in probiotics groups in some studies (26,27,30), but a lack of any significant change in others (16,22,23,25,28,29,35,36).…”

“…On the basis of the demonstration of anti-H. pylori activity of probiotics such as Lactobacillus, Saccharomyces boulardii, and Bifidobacterium, in in vitro and experimental models of H. pylori infection (19), probiotics have been suggested to improve H. pylori eradication and reduce side effects during therapy (17,20,21). However, findings from clinical studies on the use of probiotics as an adjuvant therapy to H. pylori infection have been inconsistent, with the demonstration of reduced side effects of antibiotics and improved eradication rates in some studies (16,(22)(23)(24)(25)(26)(27)(28)(29)(30), while no significant effects of adjuvant probiotics on eradication rates (22,(31)(32)(33)(34)(35)(36) or side effects (26,27,30,31,32,33,(35)(36)(37) have been reported in other studies.…”

Is There a Role for Probiotics in Helicobacter pylori Therapy?

“…28 This also was reflected in 2 other trials from Iran and Brazil where multistrain probiotics as adjunct therapy failed to show a benefit for eradication. 29,30 Bifidobacterium infantis has also been proposed as having anti-H pylori activity, and in a recent study from Asia, it was observed that adding it to standard triple therapy increased the cure rate from 69% to 83% and when pretreatment with 2 weeks of B infantis was given as well, the success rate of eradication increased to 91%. 31 If eradication regimens take into account local and regional resistance patterns and use optimized acid suppressant therapy, adjunct probiotic therapy seems add little to treatment efficacy.…”

“…31 If eradication regimens take into account local and regional resistance patterns and use optimized acid suppressant therapy, adjunct probiotic therapy seems add little to treatment efficacy. 29,30 In scenarios characterized by low H pylori eradication rates, the addition of L reuteri may lead to a therapeutic gain of 10%. 27 The strength of probiotics as add-on therapy, however, is their ability to reduce antibiotic side effects and thereby improve adherence.…”

Helicobacter pylorieradication in West Asia: A review

“…Only one of the studies could achieve 90% PP eradication rate [52,79,84] . However, if a Clarithromycincontaining 4-drug regimen is to be tried, hybrid therapy may be a better option since it has higher success rates.…”