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.
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.”