Meta-analysis: the Effect of Lactobacillus Supplementation on <i>Helicobacter pylori</i> Eradication Rates and Side Effects during Treatment

Choi, Ju Young; Shim, Ki Nam; Kong, Kyoung Ae; Kwon, Kyoung Joo; Song, Eun Mi; Kim, Seong Eun; Jung, Hye Kyung; Jung, Sung Ae

doi:2012.12.2.88

Korean J Helicobacter Up Gastrointest Res > Volume 12(2); 2012 > Article

Original Article

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(2):88-95.
DOI: https://doi.org/10.7704/kjhugr.2012.12.2.88 Published online June 1, 2012.

Meta-analysis: the Effect of Lactobacillus Supplementation on Helicobacter pylori Eradication Rates and Side Effects during Treatment

Ju Young Choi, Ki Nam Shim, Kyoung Ae Kong, Kyoung Joo Kwon, Eun Mi Song, Seong Eun Kim, Hye Kyung Jung, Sung Ae Jung

¹Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr
²Clinical Trial Center, Ewha Womans University Medical Center, Seoul, Korea.

Helicobacter pylori 제균치료 시 젖산균의 병합치료가 제균율과 부작용에 미치는 영향에 대한 메타분석

최주영, 심기남, 공경애¹, 권경주, 송은미, 김성은, 정혜경, 정성애

이화여자대학교 의학전문대학원 내과학교실, 이화여자대학교 의료원 임상시험센터¹

Abstract

BACKGROUND/AIMS
Helicobacter pylori (H. pylori) is causally associated with gastritis and peptic ulcer diseases. Recent data have demonstrated that triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor has an eradication rate of only 74~76% and new therapeutic protocols may be necessary. The aim of this study was to investigate the effects of Lactobacillus as supplementation to anti-H. pylori regimens on H. pylori eradication rates and therapy-associated side effects. MATERIALS AND METHODS: The PubMed, Medline and Korean Medical Database were searched in January 2012, with no language restrictions, for randomized controlled trials; additional references were obtained from reviewed articles. We included trials comparing Lactobacillus supplementation to placebo or no treatment during anti-H. pylori regimens. Meta-analysis was performed with Review Manager. RESULTS: Eleven trials involving a total of 1,107 participants met the inclusion criteria. Compared with placebo or no intervention, Lactobacillus given along with anti-H. pylori regimens significantly increased the eradication rate [84.7% vs. 78.8%, odds ratio (OR) 1.75, 95% confidence interval (CI) 1.26~2.42] and reduced the risk of overall H. pylori therapy related adverse effects (35.4% vs. 48.6%, OR 0.56, 95% CI 0.38~0.81), particularly of diarrhea (7.5% vs. 20.6%, OR 0.31, 95% CI 0.18~0.54), bloating (19.2% vs. 29.9%, OR 0.53, 95% CI 0.32~0.88) and taste disturbance (17.6% vs. 34.8%, OR 0.37, 95% CI 0.21~0.64). There were no significant differences between groups in the risk of other adverse effects. CONCLUSIONS: Our review suggests that supplementation with Lactobacilli could be effective in increasing eradication rates of anti-H. pylori therapy. Furthermore, Lactobacilli showed a positive impact on some H. pylori therapy-related side effects, particularly diarrhea, bloating and taste disturbance.

Key Words: Helicobacter pylori; Lactobacillus; Eradication; Side effects