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Adding Probiotic Compound to H. Pylori Eradication Treatment Doesn’t Curb Adverse Effects

After noticing the ample adverse effects of second-line Helicobacter pylori eradication treatments that utilize tetracycline, furazolidone and proton-pump inhibitors, one group of gastroenterologists set to work adding a probiotic compound to the regimen in an attempt to increase the stomach bacteria’s eradication rate while curbing those unwanted effects.
 
In their randomized, double-blind, placebo-controlled study published in the March 26 issue of BMC Gastroenterology, Tomás Navarro-Rodriguez, MD, of the Hospital Clinic of the University of São Paulo School of Medicine, in Brazil, and colleagues split 107 H. pylori-positive patients with no prior treatment for the bacteria into two groups. Both groups received 30 milligrams of lansoprazole, 200 milligrams of furazolidone and 500 milligrams of tetracycline twice daily for seven straight days, though one group also received a probiotic consisting of Lactobacillus rhamnosus, Bifidobacterium bifidum and Streptococcus faecium for 30 days, while the other group received a placebo in the probiotic’s place over the same time period.
 
Though the authors note the original aim of the study was to “minimize the adverse effects and increase the eradication rate applying the association of a probiotic compound to second-line therapy regimen,” after performing upper digestive endoscopies, histological assessments, rapid urease tests and breath tests before eradication treatment and eight weeks following it — as well as evaluating patient questionnaires on dyspeptic symptoms and common adverse effects to treatment at initial visit, seven days, one month and 60 days — the researchers concluded their probiotic compound “did not show an increase in bacterial eradication effectiveness or decrease in adverse effects of H. pylori eradication treatment” compared to placebo in the 51 peptic ulcer patients and the 56 functional dyspepsia patients.
 
While the researchers noticed a difference in the incidence and severity of adverse effects due to treatment between the two groups — as the rate of adverse effects was 59.3 percent with probiotic compared to 71.2 percent with placebo at seven days, and 44.9 percent with probiotic compared to 60.4 percent with placebo at 30 days — they acknowledge the data lacked statistical significance. Nevertheless, the authors hold out hope for probiotic compounds in future studies on second-line H. pylori eradication treatments.
 
“If probiotics can reduce the adverse effects of H. pylori eradication, it could enable greater adherence to treatment and could increase the eradication rate by intention to treat,” the authors write. “Thus, it is necessary to seek other probiotic combinations, or other presentations, or other dosages, or other treatment duration to achieve these goals.”


Further Reading
Experimental drug RHB-105, a fixed-dose combination therapy of two antibiotics and a proton pump inhibitor, will be tested in patients with confirmed H. pylori infection.
Optimized nonbismuth quadruple regimens, either hybrid or concomitant, have a cure rate of more than 90 percent for Helicobacter pylori (H. pylori) infections.
German biotech firms are working a formulation for IMX101, a multicomponent recombinant vaccine against Helicobacter pylori, a bacterium linked to gastric ulcers.
Geographic site, demographic factors, adherence to initial therapy, and infection recurrence may be as important as the choice of antibiotic regimen in Helicobacter pylori infection eradication interventions, according to a study published in the Feb. 13 issue of the Journal of the American Medical Association.
Long-term use of low-dose aspirin (LDA) is associated with increased risk of developing peptic ulcers in patients without a previous history of the condition.
Study supports the current practice of post-surgery H. pylori eradication in patients with perforated peptic ulcers.
Risk of recurrent ulcer bleeding is low in long-term low-dose aspirin (ASA) users with a history of ulcer bleeding and eradication of Helicobacter pylori (H. pylori), but high in ASA users with a history of ulcer bleeding and negative for H. pylori, according to research published in the March issue of Gastroenterology.
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