Related Experiment Video
Updated: Jul 16, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Helicobacter pylori eradication: a randomized prospective study of triple therapy versus triple therapy plus
Nicola de Bortoli1, Giulia Leonardi, Eugenio Ciancia
1Department of Medical and Surgical Gastroenterology, University of Pisa, Pisa, Italy.
Objectives:
Helicobacter pylori is causally associated with gastritis and peptic ulcer diseases. Recent data (meta-analysis) have demonstrated that triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor has an eradication rate of only 74-76% and new therapeutic protocols may be necessary. The aim of this study was to examine whether adding bovine lactoferrin (bLf) and probiotics (Pbs) to the standard triple therapy for H. pylori infection could improve the eradication rate and reduce side effects.
Methods:
H. pylori infection was diagnosed in 206 patients: in 107 based on an upper endoscopy exam and a rapid urease test, and in 99 by means of the H. pylori stool antigen-test and the C(13) urea breath test (C(13) UBT). The patients were randomized into two groups: 101 patients (group A) underwent standard triple eradication therapy (esomeprazole, clarithromycin, amoxicillin), while 105 patients (group B) underwent a modified eradication therapy (standard triple eradication therapy plus bLf and Pb). Successful eradication therapy was defined as a negative C(13) UBT 8 wk after completion of the treatment. Results were evaluated by intention-to-treat (ITT) and per-protocol (PP) analysis. Data were evaluated and considered positive when P<0.05.
Results:
At the end of the study 175/206 patients showed negative C(13) UBT results. According to intention-to-treat analysis, the infection was eradicated in 73/101 patients from Group A and in 93/105 from Group B. PP analysis showed 73/96 patients from Group A and 93/101 from Group B to have been successfully treated. More patients from group A than from group B reported side effects from their treatment (P<0.05).
Conclusions:
The results of our study suggest that the addition of bLf and Pbs could improve the standard eradication therapy for H. pylori infection--bLf serving to increase the eradication rate and Pbs to reduce the side effects of antibiotic therapy.
Insights
Adding bovine lactoferrin (bLf) and probiotics (Pbs) to standard triple therapy significantly improved Helicobacter pylori eradication rates. This enhanced regimen also reduced treatment side effects, offering a promising new protocol for H. pylori infection.
Area of Science:
- Gastroenterology
- Microbiology
- Pharmacology
Background:
- Helicobacter pylori infection is a primary cause of gastritis and peptic ulcer disease.
- Standard triple therapy for H. pylori eradication shows suboptimal efficacy (74-76% eradication rates).
- Novel therapeutic strategies are needed to improve H. pylori treatment outcomes.
Purpose of the Study:
- To evaluate the efficacy of adding bovine lactoferrin (bLf) and probiotics (Pbs) to standard triple therapy for H. pylori eradication.
- To assess the impact of bLf and Pbs on reducing treatment-related side effects.
- To determine if this modified therapy improves upon current eradication rates.
Main Methods:
- A randomized controlled trial involving 206 H. pylori-infected patients.
- Group A received standard triple therapy (esomeprazole, clarithromycin, amoxicillin).
- Group B received standard triple therapy plus bLf and Pbs. Eradication confirmed by C(13) urea breath test (UBT) 8 weeks post-treatment.
Main Results:
- The modified therapy group (Group B) demonstrated higher eradication rates in both intention-to-treat (93/105) and per-protocol (93/101) analyses compared to the standard group (Group A: 73/101 ITT, 73/96 PP).
- Significantly fewer patients in Group B reported treatment-related side effects compared to Group A (P<0.05).
- Overall, 175/206 patients achieved negative C(13) UBT results post-treatment.
Conclusions:
- The addition of bovine lactoferrin (bLf) and probiotics (Pbs) to standard triple therapy enhances Helicobacter pylori eradication rates.
- Probiotics (Pbs) appear to play a role in mitigating the side effects associated with antibiotic treatment for H. pylori.
- This combined approach represents a potentially more effective and tolerable therapeutic option for H. pylori infections.
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