title: Efficacy of Clostridium butyricum preparation concomitantly with Helicobacter pylori eradication therapy in relation to changes in the intestinal microbiota.
abstract: Antibiotic associated diarrhea due to human intestinal microbiota abnormalities is a side effect of H. pylori eradication therapy. We examined intestinal microbiota changes during H. pylori eradication therapy and the preventive effect of CBM588 as a probiotic agent. Nineteen patients with gastro-duodenal ulcer were randomly divided into three groups: group A (without probiotics), group B (with regular doses of CBM588) and group C (with double doses of CBM588). The incidence of diarrhea and soft stools during H. pylori eradication therapy was 43% in group A and 14% in group B, while none of the patients in group C reported diarrhea or soft stools. Both bacterial counts and detection rates of bifidobacteria and/or obligate anaerobe were decreased by eradication therapy. However, bacterial counts of obligate anaerobes in group C were significantly higher than in group A (P < 0.05). Additionally, during eradication therapy C. difficile toxin A was detected in both group A and group B but not in group C. In conclusion, these results indicate that H. pylori eradication therapy induces antibiotic associated diarrhea due to abnormalities in intestinal microbiota and/or C. difficile. However, these side effects might be prevented by probiotics.
authors.affiliation: Third Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, Japan. imasek@kyorin-u.ac.jp
authors.forename: Kyoto
authors.initials: K
authors.lastname: Imase
authors.forename: Motomichi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Akifumi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Kengo
authors.initials: K
authors.lastname: Tokunaga
authors.forename: Hajime
authors.initials: H
authors.lastname: Sugano
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kamiya
authors.forename: Shin'ichi
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001427:Bacterial Toxins / Q000032:analysis; D046972:Clostridium butyricum / Q000254:growth & development*; D015169:Colony Count, Microbial; D003967:Diarrhea; D004768:Enterotoxins / Q000032:analysis; D005243:Feces / Q000737:chemistry; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy*; D019936:Probiotics / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile