title: Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy?
abstract: BACKGROUND
  The standard triple therapy for the eradication of Helicobacter pylori consists of a combination of a proton pump inhibitor at a standard dose together with two antibiotics (amoxicillin 1000 mg plus either clarithromycin 500 mg or metronidazole 400 mg) all given twice daily for a period of 7-14 days. Recent reports have shown a dramatic decline in the rate of H. pylori eradication utilizing standard triple therapy from 95% down to 70-80%.
  
  
  OBJECTIVE
  Our study was designed to evaluate the effect of adding a probiotic as an adjuvant to common regimens used for H. pylori eradication.
  
  
  METHODS
  An open label randomized observational clinical study was designed to test three different regimens of H. pylori eradication treatment: Standard triple therapy with a concomitant probiotic added at the same time (n = 100), starting the probiotic for 2 weeks before initiating standard triple therapy along with the probiotic (n = 95), and the third regimen consists of the probiotic given concomitantly to sequential treatment (n = 76). The three arms were compared to a control group of patients treated with the traditional standard triple therapy (n = 106).
  
  
  RESULTS
  The eradication rate for the traditional standard therapy was 68.9%, and adding the probiotic "Bifidus infantis" to triple therapy, led to a successful rate of eradication of 83% (P < 0.001). Pre-treatment with 2 weeks of B. infantis before adding it to standard triple therapy increased the success rate of eradication to 90.5%. Similar improvement in eradication rate was noted when B. infantis was added as an adjuvant to the sequential therapy leading to an eradication rate of 90.8%.
  
  
  CONCLUSIONS
  Adding B. infantis as an adjuvant to several therapeutic regimens commonly used for the eradication of H. pylori infection significantly improves the cure rates.
authors.affiliation: Department of Gastroenterology, ADSC Center, Sharjah, United Arab Emirates. aidajani@eim.ae
authors.forename: Asad I
authors.initials: AI
authors.lastname: Dajani
authors.forename: Adnan M
authors.initials: AM
authors.lastname: Abu Hammour
authors.forename: Ding H
authors.initials: DH
authors.lastname: Yang
authors.forename: Peter C
authors.initials: PC
authors.lastname: Chung
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Nounou
authors.forename: KaiTao Y
authors.initials: KY
authors.lastname: Yuan
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Zakaria
authors.forename: Hanping S
authors.initials: HS
authors.lastname: Schi
mesh_terms: D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001644:Bifidobacterium; D017291:Clarithromycin / Q000008:administration & dosage; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005767:Gastrointestinal Diseases / Q000382:microbiology / Q000628:therapy*; D016481:Helicobacter Infections / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin