Saudi Journal of Gastroenterology
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Year : 2013  |  Volume : 19  |  Issue : 3  |  Page : 113-120

Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy?

1 Department of Gastroenterology, ADSC Center, Sharjah, United Arab Emirates
2 Department of Gastroenterology, Dubai Health Care City, United Arab Emirates
3 Department of Hepatobiliary Disease, Southern Medical University, Guangzhou, China
4 Division of Head and Neck Surgery, The 9th People's Hospital, Shanghai, China
5 Department of Gastroenterology, MNC Sharjah, United Arab Emirates
6 Department of Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
7 Department of Gastroenterology, HMC, Sharjah, United Arab Emirates

Correspondence Address:
Asad I Dajani
Sharjah P.O. Box 6328
United Arab Emirates
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.111953

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Background: The standard triple therapy for the eradication of Helicobacter pylori consists of a combination of a proton pump inhibitor at a standard dose together with two antibiotics (amoxicillin 1000 mg plus either clarithromycin 500 mg or metronidazole 400 mg) all given twice daily for a period of 7-14 days. Recent reports have shown a dramatic decline in the rate of H. pylori eradication utilizing standard triple therapy from 95% down to 70-80%. Aims: Our study was designed to evaluate the effect of adding a probiotic as an adjuvant to common regimens used for H. pylori eradication. Materials and Methods: An open label randomized observational clinical study was designed to test three different regimens of H. pylori eradication treatment: Standard triple therapy with a concomitant probiotic added at the same time (n = 100), starting the probiotic for 2 weeks before initiating standard triple therapy along with the probiotic (n = 95), and the third regimen consists of the probiotic given concomitantly to sequential treatment (n = 76). The three arms were compared to a control group of patients treated with the traditional standard triple therapy (n = 106). Results: The eradication rate for the traditional standard therapy was 68.9%, and adding the probiotic "Bifidus infantis" to triple therapy, led to a successful rate of eradication of 83% (P < 0.001). Pre-treatment with 2 weeks of B. infantis before adding it to standard triple therapy increased the success rate of eradication to 90.5%. Similar improvement in eradication rate was noted when B. infantis was added as an adjuvant to the sequential therapy leading to an eradication rate of 90.8%. Conclusion: Adding B. infantis as an adjuvant to several therapeutic regimens commonly used for the eradication of H. pylori infection significantly improves the cure rates.

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