The Effect of Probiotics on Helicobacter Pylori Eradication Rates

Probiotics as a Helicobacter Pylori treatment

Some people think that probiotics can help you get rid of Helicobacter pylori, a bacteria that can cause stomach problems. But there is not a lot of research on this yet. In one study, researchers gave probiotics to adults and children taking antibiotics to get rid of Helicobacter pylori. They found that the probiotics helped increase the eradication rate (the rate at which drugs eliminated the bacteria). They also found that the probiotics reduced the side effects of antibiotics.

What is Eradication Therapy?

Eradication therapy has long been used widely to eliminate Helicobacter pylori (H. pylori), a bacteria known to cause stomach problems. However, the classic one-week triple therapy – a combination of a proton pump inhibitor (PPI), clarithromycin, and amoxicillin – is becoming less effective, with eradication rates as low as 50%-70% and increasing resistance rates to antibiotics in some areas. PPIs are medicines that reduce stomach acid produced by glands in the stomach lining. The high rates of antibiotic-associated side effects may be due to poor patient compliance.

Probiotics as an Adjuvant after Eradication Therapy

Some people have tried giving probiotics to adults and children to improve H. pylori eradication rates and reduce the side effects of PPI-based therapies. However, it is unclear when probiotics should be given as an adjuvant to triple therapy. Most studies have started giving probiotics immediately after the triple therapy and have given them for one to four weeks.

Lactobacillus acidophilus (L.acidophilus) is a bacteria that lives in the human gut and is sometimes added to food and milk. Compared to other types of lactobacilli, L. acidophilus helps treat H. pylori infections. 

In this study, we looked at whether giving people probiotics before or after eradication therapy for H. pylori would make them more likely to be cured of the infection. 

The Study on Probiotics for Pylori-Positive Patients

This trial was conducted in 228 H. pylori-positive patients with gastritis or dyspepsia. They were randomly grouped into three:

  1. 78 in the OCA group underwent a one-week standard triple therapy consisting of 20 milligrams (mg) of omeprazole, 500 mg of clarithromycin, and 1000 mg of amoxicillin, taken twice a day;
  2. 76 in the POCA group had two weeks of pre-treatment with probiotics tablets that contain L. acidophilus, Streptococcus faecalis, and Bacillus Subtilis before the one-week triple therapy; 
  3. 74 in the OCAP group had one week of triple therapy followed by two weeks of the same probiotics mixture.

The patients took the probiotics in two tablets, three times a day, 30 minutes after a meal. Successful eradication was based on a negative C13 or C14 urease breath test result four weeks after eradication therapy. Patients were asked to report related symptoms at baseline and during follow-up, and side effects of the treatment were recorded. 

The Results

Successful eradication was observed in 171 out of 228 patients, equivalent to 75%. The eradication rates were considerably higher in the POCA and OCAP groups (81.6% and 82.4%, respectively) than in the OCA group (61.5%). 

The Conclusion

The results suggest that pre- or post-administration of probiotics may improve the H. pylori eradication effect of standard triple therapy, with post-treatment being slightly more effective than pre-treatment.

Reference

Adjuvant Probiotics Improve the Eradication Effect of Triple Therapy for Helicobacter Pylori Infection

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