Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study

Background/aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed H. pylori infection and who were randomized into two groups: Group I - 77 patients underwent triple eradication therapy, a period of 7 days, with Lansoprazole, 2 x 30 mg half an hour before a meal, Amoxicillin 2 x 1000 mg per 12 hours and Clarithromycin 2 x 500 mg per 12 hours. After the 7-th day of the therapy is continued Lansoprazole at a dose of 30 mg for half an hour before breakfast for 4 weeks; Group II - 90 patients received the same treatment as the patients of the first group, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Control of eradication of H. pylori infection was assessed 8 weeks after therapy with rapid urease test and histopathologic evaluation of endoscopic biopsies or stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, p˂0.05. The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. The addition of multiple probiotic strains triple eradication H. pylori therapy achieved significantly better eradication success and fewer side effects of antibiotics.