Effects of probiotic addition to standard treatment of Helicobacter pylori on eradication success and side effect profile

Year 2024, Volume: 7 Issue: 4, 366 - 370, 30.07.2024

Ece Yiğit , Gökhan Yılmaz

https://doi.org/10.32322/jhsm.1460718

Abstract

Aims: To reveal the effect of probiotics added to standard Helicobacter pylori eradication treatment on the eradication success and side effect profile.
Methods: This is a prospective cross-sectional study that included male and female patients between the ages of 18-65 who presented to internal medicine and general surgery outpatient clinics with dyspeptic complaints and had a positive stool Helicobacter pylori antigen test. The patients were divided into two groups with the first receiving standard treatment consisting of amoxicillin 1000 mg 2x1, clarithromycin 500 mg 2x1, and lansoprazole 30 mg 2x1. In addition to standard treatment, the second group also received a probiotic supplement containing 1.5 billion colony-forming units (CFU) per tablet twice a day. Both groups were treated for 14 days and were called 1 month later for a stool Helicobacter pylori antigen check. In addition, a questionnaire was administered to the patients aiming to determine the presence and severity of common side effects due to antibiotic use. These side effects were determined as epigastric burning, flatulence, diarrhea, nausea and vomiting, bitter taste and retrosternal burning. 0 means none, 1 means mild, 2 means moderate, and 3 means severe. Patients were asked to score the symptoms they felt while using antibiotics according to this scale. The aim was to investigate whether there was a difference between the two groups in terms of eradication success and side effect profile.
Results: The study included 150 patients (87 males and 63 females) with a mean age of 43.37±12.13 (range 23-65). Group 1 consisted of seventy-five patients who received only antibiotic treatment and group 2 consisted of 75 patients who received antibiotic and probiotic treatment. Eradication percentage was 77.33% in the antibiotic group and 85.33% in the antibiotic+probiotic group. On the other hand, the difference between groups was found to be non-significant (p=0.295). The odds ratio for association between treatment and eradication was 1.705 (95% CI: 0.738-3.940, p=0.212). The percentages of epigastric burning, flatulence, diarrhea, and nausea/vomiting were significantly higher in the antibiotic group than in the antibiotic+probiotic group (p<0.001, p<0.001, p<0.001, p=0.002, respectively). No significant differences between treatment groups in terms of bitter taste and retrosternal burning were found (p=0.323, p=0.579, respectively).
Conclusion: Probiotics cannot be an alternative option to antibiotics in the treatment of Helicobacter pylori; however, when used in combination with antibiotics, they can have a synergistic effect by increasing the eradication success and reducing side effects.

Keywords

Helicobacter pylori, gastritis, probiotics, antibiotics

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