A systematic review and meta-analysis was performed to determine the effect of probiotic-supplemented bismuth quadruple therapy (BQT) in the management of H. pylori infection.

A comprehensive search across the Cochrane Central Register of Controlled Trials, Web of Science,  Embase, and PubMed was carried out to compile randomized controlled studies meeting specified inclusion criteria. Employing the Mantel–Haenszel random-effects model, researchers calculated pooled risk ratios (RRs) and 95% confidence intervals (CIs) to assess the rates of eradication, overall side effects, diarrhea, and other adverse effects.

A total of ten studies were selected for inclusion. The combined RRs for the elimination rates in both intention-to-treat and per-protocol examinations of the probiotic group compared to the control group were 1.07 (95% CI: 1.02–1.11) and 1.04 (95% CI: 1.00–1.07), correspondingly. Supplementation with probiotics lessened the occurrences of adverse effects (RR 0.58, 95% CI: 0.37–0.91), gastrointestinal upset (RR 0.41, 95% CI: 0.25–0.67), and unpleasant taste (RR 0.63, 95% CI: 0.40–0.99).

The findings from this current study endorse the incorporation of probiotics alongside BQT in the clinical care of individuals battling H. pylori infection. However, further investigation is warranted to  determine the optimal approach for adding probiotics in H. pylori mitigation.