The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-controlled triple-blind study.

Abstract

BACKGROUND:

Evidence has shown benefits of single-strain probiotics for Helicobacter pylori eradication. We investigated the effects of adding a multistrain probiotic compound on bismuth-containing quadruple therapy for H. pylori infection.

MATERIALS AND METHODS:

Adult patients with peptic ulcer disease and confirmed H. pylori infection (n = 180) were randomized to receive bismuth-containing quadruple therapy (omeprazole, bismuth subcitrate, amoxicillin, and clarithromycin) plus a probiotic compound or placebo for 2 weeks. The probiotic compound contained seven bacterial species including Lactobacillus and Bifidobacterium strains and Streptococcus thermophiles. Eradication of H. pylori was assessed 4 weeks after medication by (13) C urea breath test. Other outcomes were dyspepsia symptoms, therapy-related adverse effects, and patient's tolerance.

RESULTS:

Eighty-four patients in the probiotic and 86 in the placebo group completed the trial. With per-protocol (intention to treat) analysis, H. pylori was eradicated in 82.1% (76.6%) of the probiotic and 84.8% (81.1%) of the placebo group, p = .392 (0.292). Symptoms were significantly improved with similar trends in both groups. Regarding the adverse effects, diarrhea was less frequent (2.2 vs 11.1%, p = .016), while abdominal pain was more frequent (10 vs 2.2%, p = .029) in the probiotic group. The two groups were similar in treatment tolerance (p = .851).

CONCLUSIONS:

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.

• Authors: Ahmad Shavakhi, Elham Tabesh, Arezoo Yaghoutkar, Houriye Hashemi, Faezeh Tabesh, Mahsa Khodadoostan, Mohammad Minakari, Sara Shavakhi, Ali Gholamrezaei
• Journal: Helicobacter (Helicobacter) Vol. 18 Issue 4 Pg. 280-4 (Aug 2013) ISSN: 1523-5378 [Electronic] England
• PMID: 23433200 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 John Wiley & Sons Ltd.

Chemical References

• Anti-Bacterial Agents
• Placebos
• Urea
• Bismuth

Topics

• Adult
• Aged
• Anti-Bacterial Agents (administration & dosage)
• Bismuth (administration & dosage)
• Breath Tests
• Female
• Helicobacter Infections (drug therapy)
• Humans
• Male
• Middle Aged
• Peptic Ulcer (drug therapy)
• Placebos (administration & dosage)
• Probiotics (administration & dosage)
• Treatment Outcome
• Urea (analysis)