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Treating bugs with bugs: the role of probiotics as adjunctive therapy for Helicobacter pylori
Sheila M Wilhelm1, Jennifer L Johnson, Pramodini B Kale-Pradhan
1Wayne State University, and Harper University Hospital, Detroit, MI, USA.
Objective:
To review the literature on the role of probiotics as adjunctive therapy in the treatment of Helicobacter pylori infections.
Data Sources:
Literature was accessed through MEDLINE (1966-March 2011) using the terms H. pylori, probiotic, Lactobacillus, Bifidobacterium, Saccharomyces, Bacillus clausii, and Propionibacterium. Article references were hand-searched for additional relevant articles and abstracts.
Study Selection And Data Extraction:
All English-language articles published in full were evaluated. Randomized, double-blind, placebo-controlled trials assessing the use of probiotics combined with standard eradication therapy of H. pylori infection in adults were included in the review.
Data Synthesis:
Various probiotics, including Lactobacillus spp., Saccharomyces spp., Bifidobacterium spp., and B. clausii, reduce adverse effects such as nausea, taste disturbance, diarrhea, and epigastric pain, and increase tolerability of H. pylori eradication therapy. Based on the studies reviewed, probiotics do not affect H. pylori eradication rates.
Conclusions:
Probiotics may be beneficial in reducing adverse effects and increasing tolerability of H. pylori eradication regimens. They may especially be helpful in patients with recurrent H. pylori infection and a history of gastrointestinal adverse effects with antibiotics. Pharmacists can play an important role in educating patients regarding probiotic use during H. pylori eradication therapy.
Insights
Probiotics can help reduce side effects from Helicobacter pylori treatment, improving patient tolerance. However, they do not increase the effectiveness of the eradication therapy itself.
Area of Science:
- Microbiology and Gastroenterology
- Pharmacology and Therapeutics
Background:
- Helicobacter pylori (H. pylori) infection is a common cause of gastrointestinal diseases.
- Standard H. pylori eradication therapy involves antibiotics, which can cause significant adverse effects.
- Adjunctive therapies are sought to improve treatment tolerability and patient compliance.
Purpose of the Study:
- To review the existing literature on the efficacy of probiotics as an add-on treatment for H. pylori infections.
- To assess the impact of probiotics on H. pylori eradication rates and treatment-related side effects.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE and hand-searching article references.
- Included studies were randomized, double-blind, placebo-controlled trials in adults using probiotics with standard H. pylori eradication therapy.
- English-language, full-text articles were evaluated.
Main Results:
- Probiotics, including Lactobacillus, Bifidobacterium, Saccharomyces, and Bacillus clausii, significantly reduced adverse effects like nausea, diarrhea, and abdominal pain.
- The use of probiotics improved the overall tolerability of H. pylori eradication regimens.
- Probiotics did not demonstrate a significant impact on the H. pylori eradication rates themselves.
Conclusions:
- Probiotics may serve as a beneficial adjunctive therapy for H. pylori eradication, primarily by mitigating antibiotic-induced side effects.
- Patients experiencing recurrent H. pylori infections or a history of gastrointestinal adverse effects may particularly benefit from probiotic supplementation.
- Healthcare professionals, including pharmacists, should educate patients on the appropriate use of probiotics during H. pylori treatment.
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