The Efficacy of<i>Saccharomyces boulardii</i>CNCM I-745 in Addition to Standard<i>Helicobacter pylori</i>Eradication Treatment in Children

Zhang, Bin; Xu, Ya-zheng; Deng, Zhongliang; Chu, Bo; Jiang, Lirong; Vandenplas, Yvan

doi:10.5223/pghn.2015.18.1.17

Cited by 42 publications

(34 citation statements)

References 24 publications

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“…Figure S1 documents the identification process for eligible trials. In addition to the previously identified five RCTs, 16 new trials were included . Except for three trials published in Chinese, Portuguese and Spanish for which the translation was obtained, all of the remaining trials were published in English.…”

Section: Resultsmentioning

confidence: 99%

“…In addition to the previously identified five RCTs, [13][14][15][16][17] 16 new trials were included. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Except for three trials published in Chinese, 18 Portuguese 19 and Spanish 20 for which the translation was obtained, all of the remaining trials were published in English. Table S1 summarises characteristics of all the included RCTs, and Table S2 summarises characteristics of the excluded trials, including the reasons for exclusion.…”

Section: Search Strategymentioning

confidence: 99%

“…Based on the findings from six RCTs, there was no need for discontinuation of antibiotic treatment. 13,22,25,27,28,32 Based on data from two RCTs, there was no need for hospital treatment because of diarrhoea in the out-patients or intravenous rehydration in any of the study groups. 13,22 Adverse events.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

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Systematic review with meta‐analysis: Saccharomyces boulardii in the prevention of antibiotic‐associated diarrhoea

Szajewska

Kołodziej

2015

Aliment Pharmacol Ther

165

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Summary Background Antibiotic‐associated diarrhoea is a common complication of antibiotic use, but it can be prevented with administration of probiotics. Aim To update our 2005 meta‐analysis on the effectiveness of Saccharomyces boulardii in preventing antibiotic‐associated diarrhoea in children and adults. Methods The Cochrane Library, MEDLINE, and EMBASE databases were searched up until May 2015, with no language restrictions, for randomised controlled trials; additional references were obtained from reviewed articles. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. Results Twenty‐one randomised controlled trials (4780 participants), among which 16 were new trials, met the inclusion criteria for this updated systematic review. Administration of S. boulardii compared with placebo or no treatment reduced the risk of antibiotic‐associated diarrhoea (as defined by the study investigators) in patients treated with antibiotics from 18.7% to 8.5% (risk ratio, RR: 0.47; 95% CI: 0.38–0.57, number needed to treat, NNT: 10; 95% CI: 9–13). In children, S. boulardii reduced the risk from 20.9% to 8.8% (6 randomised controlled trials, n=1653, RR: 0.43, 95% CI: 0.3–0.6); in adults, from 17.4% to 8.2% (15 randomised controlled trials, n=3114, RR: 0.49, 95% CI: 0.38–0.63). Moreover, S. boulardii reduced the risk of Clostridium difficile‐associated diarrhoea; however, this reduction was significant only in children (2 randomised controlled trials, n = 579, RR: 0.25; 95% CI: 0.08–0.73) and not in adults (9 randomised controlled trials, n = 1441, RR: 0.8, 95% CI: 0.47–1.34). Conclusions This meta‐analysis confirms that S. boulardii is effective in reducing the risk of antibiotic‐associated diarrhoea in children and adults.

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Section: Resultsmentioning

confidence: 99%

Section: Search Strategymentioning

confidence: 99%

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Systematic review with meta‐analysis: Saccharomyces boulardii in the prevention of antibiotic‐associated diarrhoea

Szajewska

Kołodziej

2015

Aliment Pharmacol Ther

165

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“…The efficacy of Saccharomyces boulardii CNCM I‐745 in addition to standard H. pylori eradication treatment in children was also studied. Although diarrhea was significantly less in the treatment group and compliance to eradication treatment was 100%, a slight but not significant increase in H. pylori eradication was achieved compared to controls .…”

Section: Diagnosismentioning

confidence: 73%

Helicobacter pylori Infection in Pediatrics

Roma

Miele

2015

Helicobacter

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This review includes the main pediatric studies published from April 2014 to March 2015. The host response of Treg cells with increases in FOXP3 and TGF‐β1 combined with a reduction in IFN‐γ by Teff cells may contribute to Helicobacter pylori susceptibility in children. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. Helicobacter pylori infection is associated with variables indicative of a crowded environment and poor living conditions, while breast‐feeding has a protective effect. Intrafamilial infection, especially from mother to children and from sibling to sibling, is the dominant transmission route. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura in H. pylori‐infected children and adolescents. The prevalence of H. pylori was higher in chronic urticaria patients than in controls and, following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. Antibiotic resistance and insufficient compliance to treatment limit the efficacy of eradication therapy. Sequential therapy had no advantage over standard triple therapy. In countries where H. pylori infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality.

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“…Furthermore, probiotic combinations can reduce adverse side effects induced by antibiotics, although continuing studies comprised of a larger number of patients, are necessary to further evaluate the efficacy of probiotics as a supplement of antibiotic therapy, in the treatment of the H. pylori infection [24,25]. Here, the cooperation of healthcare providers, researchers, patients (children) and their parents is highly appreciated to perform such efforts.…”

Section: Discussionmentioning

confidence: 99%

Probiotics as Dietary Supplements for Eradication of Helicobacter pylori Infection in Children: A Role Beyond Infection

Hassan

Šudomová

2016

Children

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For decades, treatment of infectious diseases has been a strong focus of interest, for both researchers and healthcare providers. Chronic infection with Helicobacter pylori (H. pylori) has been reported to be associated with several diseases, such as ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Infection with H. pylori is generally acquired during childhood and can persist indefinitely, if not treated systematically. Unfortunately, although several strategies have shown high efficacy results, treatment of the H. pylori infection fails in about 25%–30% of infected children. One main reason for this is due to the extensive use of antibiotics, which has created antibiotic resistance, associated with other adverse effects as well. Therefore, it is crucial to find alternative strategies to combat this resistance, and increase treatment efficacy results. Probiotics, which are live microorganisms that are orally administrated, have been found to be a useful regimen in the treatment of the H. pylori infection in children. Their use as a dietary supplement alone, or in combination with antibiotics, resulted in reduced side effects and higher efficacy rates of the H. pylori infection in children. Some probiotics can be considered an adjunctive treatment, especially when eradication of the H. pylori infection fails during initial treatment, and to help reduce adverse effects. However, the evidence of the beneficial role of probiotics is limited due to the small number of clinical trials that have been conducted and heterogeneity across studies in strains and dosage. Additionally, no investigations have been carried out in asymptomatic children. Therefore, large well-conducted studies are needed to evaluate the efficacy and safety of probiotics as an adjuvant therapy of the H. pylori infection.

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The Efficacy ofSaccharomyces boulardiiCNCM I-745 in Addition to StandardHelicobacter pyloriEradication Treatment in Children

Cited by 42 publications

References 24 publications

Systematic review with meta‐analysis: Saccharomyces boulardii in the prevention of antibiotic‐associated diarrhoea

Systematic review with meta‐analysis: Saccharomyces boulardii in the prevention of antibiotic‐associated diarrhoea

Helicobacter pylori Infection in Pediatrics

Probiotics as Dietary Supplements for Eradication of Helicobacter pylori Infection in Children: A Role Beyond Infection

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