Can probiotics play a role in Helicobacter pylori (H. Pylori) eradication?

Can probiotics play a role in Helicobacter pylori (H. Pylori) eradication?

BackgroundH. Pylori is one of the commonest infectious diseases worldwide. In recent years, PPI-based triple therapy has been described to be losing its efficacy against H. pylori due to high rates of antibiotic resistance, antibiotics-associated side effects, and low compliance. Probiotics are sugg...

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Bibliographic Details
Published in:Egyptian Liver Journal Vol. 13; no. 1; pp. 64 - 10
Main Authors: Fakhry, Sameh Mohamed, Kandyl, Mohamed Abdel-Hameed, Hashish, Adel Ferig, Kandeel, Wafaa, El-Shenawy, Ahmed Mostafa, El-Sayed, Hoda Samir, Dewidar, Mohamed Kamal, Badr, Sameh Mohamed, Mehanna, Nayra Shaker
Format: Journal Article
Language:English
Published: Menoufiya Springer Nature B.V 18-11-2023
SpringerOpen
Subjects:
Anemia
Antibiotics
Antibodies
Antigens
Consent
Diarrhea after antibiotics therapy
Disease
Drug resistance
Eradication therapy
Helicobacter pylori
Infections
Microbiota
Milk
Patients
Probiotics
Ulcers
Weight control
Yogurt
Egypt
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Summary:BackgroundH. Pylori is one of the commonest infectious diseases worldwide. In recent years, PPI-based triple therapy has been described to be losing its efficacy against H. pylori due to high rates of antibiotic resistance, antibiotics-associated side effects, and low compliance. Probiotics are suggested to improve the H. pylori eradication rate when added to H pylori therapy. Probiotics have anti-inflammatory and anti-oxidative mechanisms that may improve bowel microecology and interact with the microbial flora of the gastrointestinal tract to produce a beneficial effect in H Pylori eradication. Probiotics may be also responsible for the reduction of the adverse effects related to H. pylori therapy that may result in treatment failure.Aim of the workIn our study, we assessed the role of probiotics in improving the H. Pylori eradication rate and reducing side effects after antibiotic-based therapy.Patients and methodOne hundred fifty-nine patients positive for H. pylori stool antigen and had never received previously H. pylori eradication therapy, were included in the study, 59 patients received triple therapy alone (Standard group) and 100 patients received triple therapy and probiotics (study group). One hundred fifty patients completed the treatment. Quantification of Lactobacilli and Bifidobacteria concentration in stool was done by PCR before and after therapy. Eradication of H. pylori was assessed in each group by H. pylori stool antigen after 4 weeks of finishing therapy.ResultsH Pylori eradication rate was higher in patients who received probiotics with standard therapy compared to those who received standard therapy alone. The improvement in the eradication rate was statistically significant when probiotics were received after standard therapy (81.04% versus 71.19%, P-Value 0.021). Short-term diarrhea after antibiotics therapy was significantly lower in patients who received probiotics especially when given before antibiotic therapy (7.50% versus 25.50%, P-value 0.0001). Probiotics may play a role to restore gut dysbiosis as evidenced by stool PCR for Lactobacilli and Bifidobacteria before and after therapy.ConclusionProbiotics have a beneficial role to improve the eradication rate of H. pylori, particularly when given after standard therapy. Adding probiotics was associated as well with less diarrhea as a side effect of antibiotic therapy.Trial registrationThe trial has been registered on the Pan African Clinical Trial Register website, No of registration, PACTR202304859303467. Registered 24 April 2023 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25434.
ISSN:2090-6218
2090-6226
DOI:10.1186/s43066-023-00294-4