The efficacy and safety of adding the probiotic Saccharomyces boulardiito standard triple therapy for eradication of H.pylori: a randomized controlled trial

Homayoun Zojaji, Mehdi Ghobakhlou, Hassan Rajabalinia, Elnaz Ataei, Somayeh Jahani Sherafat, Bijan Moghimi-Dehkordi, Rasoul Bahreiny, Homayoun Zojaji, Mehdi Ghobakhlou, Hassan Rajabalinia, Elnaz Ataei, Somayeh Jahani Sherafat, Bijan Moghimi-Dehkordi, Rasoul Bahreiny

Abstract

Aim: Evaluating the efficacy and safety of adding the probiotic Saccharomyces boulardiito standard triple therapy for eradication of Helicobacter pylori.

Background: Several probiotics such as Saccharomyces boulardii have been investigated for their clinical efficacy. This probiotic, inhibit H. pylori urease by lowering the gastric pH, adhesion of H. pylori to gastric epithelial cells, stabilize the gastric barrier function and reduce the side effects of antibiotics.

Patients and methods: In this randomized controlled trial we evaluated 160 adult patients with biopsy confirmed H. Pylori infection referred to gastroenterology ward of Taleghani hospital. The patients were randomized into two treatment regimens: patients in group A (n = 80) were given amoxicillin (1000 mg, b.i.d), clarithromycin (500 mg, b.i.d), omeprazole (20 mg, b.i.d) and probiotic of saccaromyces boularidi (Yomogi) (250 mg, b.i.d) for 14 days, moreover patients in group B (n = 80) were given amoxicillin (1000 mg, b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg,b.i.d) for 14 days.

Results: 160 patients (66 male 41.25%, 94female 58.75%) with the mean age of 47.1±11.4 years were evaluated. The success rate for H. pylori eradication in group A was higher 75(87.5%) than group B 65 (81.2%), but the difference between two groups was not significant (p = 0.350). Moreover, in case group side effects as nausea, diarrhea, abdominal discomfort and bloating were significantly lower than control group in first and second weeks.

Conclusion: This study showed that saccaromyces boularidi decreased the adverse effects associated with H.pylori therapy but did not significantly decrease the eradication rate of H.pylori.

Keywords: Anti-helicobacter pylori eradication therapy; Helicobacter pylori; Probiotic; Saccharomyces boulardii.

Figures

Figure 1
Figure 1
Esophagogastroduodenoscopy findings in cases (group A) and control (group B)

References

    1. Go MF, Crowe SE. Virulence and pathogenicity of Helicobacter pylori . Gastroenterol Clin North Am. 2000;29:649–70.
    1. Eslick GD, Lim LL, Byles JE, Xia HH, Talley NJ. Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis. Am J Gastroenterol. 1999;94:2373–79.
    1. Kearney DJ. Retreatment of Helicobacter pylori infection after initial treatment failure. Am J Gastroenterol. 2001;96:1335–39.
    1. Suerbaum S, Michetti P. Medical progress: Helicobacter pylori infection. N Engl J Med. 2002;347:1175–86.
    1. Malfertheiner P, Megraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007;56:772–81.
    1. Lessbros-Pantoflickova D, Corthesy-Theulaz I, Blum AL. Helicobacter pylori and probiotics. J Nutr. 2007;137:812–18.
    1. Hoffman FA, Heimbach JT, Sanders ME, Hibberd PL. Executive summary: scientific and regulatory challenges of development of probiotics as foods and drugs. Clin Infect Dis. 2008;46:S53–S57.
    1. Vanderhoof JA, Young R. Probiotics in the United States. Clin Infect Dis. 2008;46:S67–S72.
    1. Amagase H. Current marketplace for probiotics: a Japanese perspective. Clin Infect Dis. 2008;46:S73–S75.
    1. Saxelin M. Probiotic formulations and applications, the current probiotics market, and changes in the marketplace: a European perspective. Clin Infect Dis. 2008;46:S76–S79.
    1. McFarland LV. Evidence-based review of probiotics for antibiotic-associated diarrhea and Clostridium difficile infections. Anaerobe. 2009;15:274–80.
    1. Czerucka D, Piche T, Rampal P. Review article: yeast as probiotics-Saccharomyces boulardii. Aliment Pharmacol Ther. 2007;26:767–78.
    1. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870–76.
    1. Kim MN, Kim N, Lee SH, Park YS, Hwang JH, Kim JW, et al. The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication. Helicobacter. 2008;13:261–68.
    1. Nista EC, Candelli M, Cremonini F, Cazzato IA, Zocco MA, Franceschi F, et al. Bacillus clausiitherapy to reduce side-effects of anti-Helicobacter pylori treatment: randomized, double-blind, placebo controlledtrial. Aliment Pharmacol Ther. 2004;20:1181–88.
    1. Cindoruk M, Erkan G, Karakan T, Dursun A, Unal S. Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: a prospective randomized placebocontrolleddouble-blind study. Helicobacter. 2007;12:309–16.
    1. Sheu BS, Wu JJ, Lo CY, Wu HW, Chen JH, Lin YS, et al. Impact of supplement with Lactobacillus- and Bifidobacterium-containing yogurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2002;16:1669–75.
    1. Vandenplas Y, Brunser O, Szajewska H. Saccharomyces boulardii in childhood. Eur J Pediatr. 2009;168:253–65.
    1. Gotteland M, Poliak L, Cruchet S, Brunser O. Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus LB in children colonized by Helicobacter pylori . Acta Paediatr. 2005;94:1747–51.
    1. de Bortoli N, Leonardi G, Ciancia E, Merlo A, Bellini M, Costa F, et al. Helicobacter pylori eradication: a randomized prospective study of triple therapy versus triple therapy plus lactoferrin and probiotics. Am J Gastroenterol. 2007;102:951–56.
    1. Cremonini F, Di Caro S, Covino M, Armuzzi A, Gabrielli M, Santarelli L, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97:2744–49.
    1. Yaşar B, Abut E, Kayadıbı H, Toros B, Sezikli M, Akkan Z, et al. Efficacy of probiotics in Helicobacter pylori eradication therapy. Turk J Gastroenterol. 2010;21:212–17.
    1. Lesbros-Pantoflickova D, Corthésy-Theulaz I, Blum AL. Helicobacter pylori and Probiotics. J Nutr. 2007;137:S812–18.
    1. Wilhelm SM, Johnson JL, Kale-Pradhan PB. Treating bugs with bugs: the role of probiotics as adjunctive therapy for Helicobacter pylori . Ann Pharmacother. 2011;45:960–66.
    1. Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: A randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005;21:583–90.
    1. Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr. 2004;79:261–67.
    1. Ishibashi N, Yamazaki S. Probiotics and safety. Am J Clin Nutr. 2001;73:S465–70.
    1. Muñoz P, Bouza E, Cuenca-Estrella M, Eiros JM, Pérez MJ, Sánchez-Somolinos M, et al. Saccharomyces cerevisiaefungemia: an emerging infectious disease. Clin Infect Dis. 2005;40:1625–34.

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