title: Efficacy and safety of probiotics as adjuvant agents forHelicobacter pyloriinfection: A meta-analysis.
abstract: The aim of the present study was to determine whether probiotics could help to improve the eradication rates and reduce the side effects associated with anti-Helicobacter pyloritreatment, and to investigate the optimal time and duration of probiotic administration during the treatment, thus providing clinical practice guidelines for eradication success worldwide. By searching Pubmed, Embase, the Cochrane Central Register of Controlled Trials and the Science Citation Index, all the randomized controlled trials (RCTs) comparing probiotics as adjuvant agents of anti-H. pyloristandard triple-therapy regimens with placebo or no treatment were selected. Statistical analysis was performed with the Comprehensive Meta Analysis Software. Subgroup, meta-regression and sensitivity analyses were also carried out. Twenty-one RCTs involving a total of 3,814 participants met the inclusion criteria. The pooled eradication rates of the probiotic group were 80.3% (1,709/2,128) by intention-to-treat (ITT) and 83.8% (1,709/2,039) by pro-protocol analyses; the pooled relative risk (RR) by ITT for probiotic supplementation versus treatment without probiotics was 1.12 [95% confidence interval (CI), 1.06-1.19]. A reduced risk of overallH. pyloritherapy-related adverse effects was also found with probiotic supplementation (RR, 0.60; 95% CI, 0.40-0.91). The subgroup analyses showed that probiotic supplementation prior and subsequent to the treatment regimen both improved eradication rates forH. pyloriinfection. Furthermore, probiotic treatment lasting >2 weeks and includingLactobacillusor multiple probiotic strains significantly enhanced the efficacy. In conclusion, supplementation with probiotics forH. pylorieradication may be effective in increasing eradication rates and decreasing therapy-related side effects. Probiotic administration prior or subsequent to therapy and for a duration of >2 weeks may increase the eradication efficacy.
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Zhifa
authors: Z
authors: Lv
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Ben
authors: B
authors: Wang
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Xiaojiang
authors: X
authors: Zhou
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Fucai
authors: F
authors: Wang
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Yong
authors: Y
authors: Xie
authors: School of Public Health, Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Huilie
authors: H
authors: Zheng
authors: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China.
authors: Nonghua
authors: N
authors: Lv
keywords: Helicobacter pylori; adjuvant treatment; meta-analysis; probiotics