title: Meta-analysis: Lactobacillus containing quadruple therapy versus standard triple first-line therapy for Helicobacter pylori eradication.
abstract: BACKGROUND
  Recent evidence showed that Lactobacilli could exert an inhibitory effect on Helicobacter pylori both in vitro and in vivo models. To systematically evaluate whether adding Lactobacilli to H. pylori eradication regimens could improve eradication rates and reduce side effects during anti-H. pylori treatment.
  
  
  METHODS
  Eligible articles were identified by searches of electronic databases. We included all randomized trials comparing Lactobacilli supplementation to placebo or no treatment during anti-H. pylori regimens. Statistical analysis was performed with Review Manager 5.0.10. Subanalysis analysis was also performed.
  
  
  RESULTS
  We identified eight randomized trials (n = 1372). Pooled H. pylori eradication rates were 82.26% (95% CI = 78.01-86.51%) and 76.97% (95% CI = 73.11-80.83%) for patients with or without Lactobacilli by intention-to-treat analysis, respectively, the odds ratio (OR) was 1.78 (95% CI = 1.21-2.62). The occurrence of total side effects had no significant difference and were 30.84% (95% CI = 24.82-36.86%) and 42.24% (95% CI = 35.89%-48.59%) for two groups, the summary OR was 0.49 (95% CI = 0.24-1.02); However, Lactobacilli supplementation group had lower occurrence of diarrhoea, bloating and taste disturbance.
  
  
  CONCLUSIONS
  Our review suggests that supplementation with Lactobacilli could be effective in increasing eradication rates of anti-H. pylori therapy for first-treated patients. Furthermore, Lactobacilli showed a positive impact on some H. pylori therapy-related side effects.
authors.affiliation: Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zou
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Yu
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000898:Antibiosis; D003131:Combined Modality Therapy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007778:Lactobacillus / Q000502:physiology*; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents