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The clinical success of standard triple therapy for Helicobacter pylori (H. pylori) infection faces a steady decline due to increasing antibiotic resistance. Lactobacillus reuteri (L. reuteri) serves as a promising probiotic adjunct that potentially enhances bacterial clearance and improves patient tolerability during treatment.
Supplementing standard triple therapy with Lactobacillus reuteri significantly improves Helicobacter pylori eradication rates and minimizes common treatment-related adverse effects.
The clinical success of standard triple therapy for Helicobacter pylori (H. pylori) infection faces a steady decline due to increasing antibiotic resistance. Lactobacillus reuteri (L. reuteri) serves as a promising probiotic adjunct that potentially enhances bacterial clearance and improves patient tolerability during treatment. The study aimed to explore the efficacy and safety of adding L. reuteri to standard triple therapy for the eradication of H. pylori.
Investigators conducted a comprehensive systematic search across major medical databases, including PubMed, Embase, Cochrane Central, Web of Science, and Scopus, covering literature from inception through May 2024. The analysis included randomized controlled trials (RCTs) that compared the administration of viable L. reuteri or a placebo in conjunction with standard triple therapy. All statistical syntheses were performed using Review Manager 5.4 to assess eradication outcomes and the incidence of side effects.
The meta-analysis encompassed seven RCTs with a total of 518 patients. The results revealed that patients receiving L. reuteri supplementation achieved significantly higher eradication rates compared to those on triple therapy alone (hazard ratio [HR]: 1.16, p = 0.01). Furthermore, the addition of this probiotic markedly reduced the risk of several adverse events, specifically:
No statistically significant differences were observed between the groups regarding the occurrence of nausea, vomiting, or epigastric pain.
This updated analysis confirmed that L. reuteri supplementation effectively enhanced H. pylori eradication success while simultaneously improving the treatment's safety profile by mitigating gastrointestinal side effects. While the evidence favored probiotic integration, researchers concluded that larger-scale clinical trials were necessary to further solidify these findings and optimize therapeutic recommendations.
Open Forum Infectious Diseases
P-96. Efficacy and Safety of Lactobacillus reuteri Supplementation Combined with Triple Therapy for Eradicating Helicobacter pylori: An Updated Meta-Analysis of Randomized Controlled Trials
Omar Elkoumi et al.
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