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Evaluation of Helicobacter pylori eradication by triple therapy plus Lactobacillus acidophilus compared to triple therapy alone

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Abstract

The purpose of this study was to evaluate the influence of adding Lactobacillus acidophilus to a triple regimen for Helicobacter pylori eradication in untreated patients with peptic ulcers or ulcer-scars. This was a pre-randomized, single-blind, interventional, treatment-efficacy study with active controls and parallel-assignment, set in Coimbra, Portugal, on 62 consecutive H. pylori-positive untreated adults with peptic ulcers or ulcer-scars, diagnosed by gastroduodenoscopy, with pre-treatment direct Gram-staining and culture of gastric biopsies. The first 31 patients received esomeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg (EAC), all b.i.d., for 8 days. The remaining 31 added L. acidophilus, 5 × 109 organisms per capsule, 3 + 2 i.d. for 8 days (EACL). The main outcome measure was 13C urea breath test (UBT), ≥6 weeks after completion of therapy. Successful eradication (UBT-negativity after treatment), was similar in both groups (EAC = 80.6%; EACL = 83.9%, p = 0.740) by both intention-to-treat and per-protocol analysis. The non-eradicated strains were susceptible in vitro to both antibiotics. Adding L. acidophilus to EAC triple therapy did not increase H. pylori eradication rates. Considering the cost and the burden of ingesting five extra capsules daily, supplementing the EAC therapy with L. acidophilus, at this dose, shows no benefit. Further studies with different dosages and duration of treatment, and other probiotics or probiotic combinations are required to improve eradication.

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Acknowledgments

The authors would like to thank the “Dr. Ricardo Jorge” National Institute of Health, Portugal, for its support in the execution of the microbiology tests.

Conflict of interest statement

The authors declare that they have no conflicts of interest, including financial or personal relationships with other people or organisations, that could influence their work.

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Authors and Affiliations

  1. Institute of Physiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    J. A. da Silva Medeiros & M. I. de Correia Pereira

  2. Institute of Microbiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    T. M. F. O. Gonçalves

  3. Department of Microbiology, Medical University of Sofia, Sofia, Bulgaria

    L. Boyanova

  4. Institute of Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    J. N. da Silva Paiva de Carvalho & A. M. Silvério Cabrita

  5. Department of Educational Sciences, University of Aveiro, Aveiro, Portugal

    A. M. de Sousa Pereira

  6. Rua do Carmo, No. 54, 4V, 3000-098, Coimbra, Portugal

    J. A. da Silva Medeiros

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  1. J. A. da Silva Medeiros
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  2. T. M. F. O. Gonçalves
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  3. L. Boyanova
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  4. M. I. de Correia Pereira
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  5. J. N. da Silva Paiva de Carvalho
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  6. A. M. de Sousa Pereira
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  7. A. M. Silvério Cabrita
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Correspondence to J. A. da Silva Medeiros.

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da Silva Medeiros, J.A., F. O. Gonçalves, T.M., Boyanova, L. et al. Evaluation of Helicobacter pylori eradication by triple therapy plus Lactobacillus acidophilus compared to triple therapy alone. Eur J Clin Microbiol Infect Dis 30, 555–559 (2011). https://doi.org/10.1007/s10096-010-1119-4

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  • DOI: https://doi.org/10.1007/s10096-010-1119-4

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