%0 Journal Article %J J Clin Gastroenterol %D 2014 %T Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. %A Francavilla, Ruggiero %A Polimeno, Lorenzo %A Demichina, Antonella %A Maurogiovanni, Giovanni %A Principi, Beatrice %A Scaccianoce, Giuseppe %A Ierardi, Enzo %A Russo, Francesco %A Riezzo, Giuseppe %A Di Leo, Alfredo %A Cavallo, Luciano %A Francavilla, Antonio %A Versalovic, James %K Adolescent %K Adult %K Aged %K Anti-Bacterial Agents %K Breath Tests %K Double-Blind Method %K Drug Therapy, Combination %K Female %K Follow-Up Studies %K Gastrins %K Helicobacter Infections %K Helicobacter pylori %K Humans %K Limosilactobacillus reuteri %K Male %K Middle Aged %K Probiotics %K Prospective Studies %K Treatment Outcome %K Young Adult %X

GOALS: The goals of this study were to investigate the role of a new probiotic preparation (Lactobacillus reuteri DSM 17938 and L. reuteri ATCC PTA 6475) in Helicobacter pylori infection.

BACKGROUND: Specific probiotic strains play a role in H. pylori infection for their ability to decrease bacterial load and gastritis, prevent antibiotic-associated side effects, and increase the eradication rate.

STUDY: This is a prospective, double-blind, randomized, placebo-controlled study in a tertiary care setting. A total of 100 H. pylori-positive naive patients received either L. reuteri combination (2×10 Colony Forming Units) or placebo during a 3-phase study (pre-eradication, eradication, and follow-up). All underwent C urea breath test (C-UBT), blood assessments of gastrin-17 (G17), endoscopy, and the Gastrointestinal Symptom Rating Scale. Eradication was confirmed by C-UBT 8 weeks after the completion of therapy.

RESULTS: Fifty patients were allocated in each group. During pre-eradication period, C-UBT δ decreased by 13% in L. reuteri combination as compared with a 4% increase in placebo (-13.2±34% vs. 4.3±27%; P<0.03). During eradication, GSRS increased significantly in placebo as compared with L. reuteri combination (6.8±2.9 vs. 4±3.1; P<0.01). Significantly less patients in L. reuteri combination as compared with placebo-reported side effects (40.9% vs. 62.8%; P<0.04). An abnormal G17 value was found in patients receiving placebo as compared with L. reuteri combination (28% vs. 12%; P<0.02). Eradication rate was 75% in L. reuteri combination and 65.9% in placebo (P=NS). L. reuteri combination increased eradication rate by 9.1% (odds ratio: 1.5).

CONCLUSIONS: L. reuteri combination alone is able to exert an inhibitory effect on H. pylori growth, and when administered with eradication therapy, it determines a significant reduction in antibiotic-associated side effects. Moreover, L. reuteri combination was able to decrease serum G17 levels and to (not significantly) increase the H. pylori-eradication rate.

%B J Clin Gastroenterol %V 48 %P 407-13 %8 2014 May-Jun %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/24296423?dopt=Abstract %R 10.1097/MCG.0000000000000007