Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study.
BACKGROUND
One-week triple therapy is currently regarded as the reference of anti-Helicobacter pylori treatment. However, antibiotic-associated gastrointestinal side effects are among the major pitfalls of such regimens. Probiotic supplementation may be regarded as a therapeutic tool to prevent or reduce these troublesome drug-related manifestations.


OBJECTIVE
To determine whether the addition of the probiotic Lactobacillus GG to an anti-H. pylori standard triple therapy could help to prevent or minimize the occurrence of gastrointestinal side effects.


METHODS
One hundred and twenty healthy asymptomatic subjects screened positive for H. pylori infection and deciding to receive eradication therapy were randomized either to 1-week pantoprazole (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), tinidazole (500 mg b.i.d.) or to the same regimen supplemented with Lactobacillus GG for 14 days. Patients filled in validated questionnaires during follow-up to determine the type and severity of side effects and to judge overall tolerability.


RESULTS
Bloating, diarrhea and taste disturbances were the most frequent side effects during the eradication week and were significantly reduced in the Lactobacillus GG-supplemented group (RR = 0.4, CI 0.2-0.8; RR = 0.3, CI 0.1-0.8; RR = 0.3, CI 0.1-0.7, respectively). The same pattern was observed throughout the follow-up period. Overall assessment of treatment tolerability showed a significant trend in favor of the Lactobacillus GG-supplemented group (p = 0.03).


CONCLUSIONS
Lactobacillus GG supplementation beneficially affects H. pylori therapy-related side effects and overall treatment tolerance.
Armuzzi
A
A
Department of Internal Medicine, Catholic University, Rome, Italy.
Cremonini
F
F
Ojetti
V
V
Bartolozzi
F
F
Canducci
F
F
Candelli
M
M
Santarelli
L
L
Cammarota
G
G
De Lorenzo
A
A
Pola
P
P
Gasbarrini
G
G
Gasbarrini
A
A
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D017291:Clarithromycin / Q000009:adverse effects* / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007778:Lactobacillus; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D000077402:Pantoprazole; D010865:Pilot Projects; D013454:Sulfoxides / Q000009:adverse effects* / Q000627:therapeutic use; D013651:Taste Disorders / Q000139:chemically induced / Q000517:prevention & control; D014011:Tinidazole / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; D014011:Tinidazole; D000077402:Pantoprazole; D017291:Clarithromycin; D009853:Omeprazole