title: Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy.
abstract: OBJECTIVE
  To evaluate the role of probiotics in the standard triple Helicobacter pylori therapy.
  
  
  METHODS
  In this meta-analysis, we investigated the efficacy of probiotics in a standard triple H. pylori therapy in adults. Searches were mainly conducted in MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Fourteen studies met our criteria, and the quality of these studies was assessed using the Jadad scale. We used STATA version 12.0 to extract data and to calculate the odds ratios (ORs), which are presented with the corresponding 95% confidence intervals (CIs). The data are presented as forest plots.
  
  
  RESULTS
  The pooled ORs for the eradication rates calculated by intention-to-treat analysis and per-protocol analysis in the probiotic group vs the control group were 1.67 (95%CI: 1.38-2.02) and 1.68 (95%CI: 1.35-2.08), respectively, using the fixed-effects model. The sensitivity of the Asian studies was greater than that of the Caucasian studies (Asian: OR = 1.78, 95%CI: 1.40-2.26; Caucasian: OR = 1.48, 95%CI: 1.06-2.05). The pooled OR for the incidence of total adverse effects was signiﬁcantly lower in the probiotic group (OR = 0.49, 95%CI: 0.26-0.94), using the random effects model, with significant heterogeneity (I (2) = 85.7%). The incidence of diarrhea was significantly reduced in the probiotic group (OR = 0.21, 95%CI: 0.06-0.74), whereas the incidence of taste disorders, metallic taste, vomiting, nausea, and epigastric pain did not differ significantly between the probiotic group and the control group.
  
  
  CONCLUSIONS
  Supplementary probiotic preparations during standard triple H. pylori therapy may improve the eradication rate, particularly in Asian patients, and the incidence of total adverse effects.
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhu
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Kan
authors.initials: K
authors.lastname: Chen
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Zheng
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Hua-Wei
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Jun-Shan
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Xia
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Wei-Qi
authors.initials: WQ
authors.lastname: Dai
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Shen
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Cheng
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Cheng-Fen
authors.initials: CF
authors.lastname: Wang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lu
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Ying-Qun
authors.initials: YQ
authors.lastname: Zhou
authors.affiliation: Rong Zhu, Kan Chen, Yuan-Yuan Zheng, Hua-Wei Zhang, Jun-Shan Wang, Yu-Jing Xia, Wei-Qi Dai, Fan Wang, Miao Shen, Ping Cheng, Yan Zhang, Cheng-Fen Wang, Jing Yang, Jing-Jing Li, Jie Lu, Ying-Qun Zhou, Chuan-Yong Guo, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Chuan-Yong
authors.initials: CY
authors.lastname: Guo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000175:diagnosis / Q000208:ethnology / Q000382:microbiology / Q000628:therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000472:pathogenicity*; D006801:Humans; D016017:Odds Ratio; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Adult; Eradication; Helicobacter pylori; Meta-analysis; Probiotics