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Meta-Analysis of the Efficacy and Safety of Lactobacillus-containing and Bifidobacterium-containing Probiotic Compound Preparation in Helicobacter pylori Eradication Therapy

Wang, Zhen-Hua MD*,†; Gao, Qin-Yan MD, PhD*,†; Fang, Jing-Yuan MD, PhD*,†

Journal of Clinical Gastroenterology: January 2013 - Volume 47 - Issue 1 - p 25–32
doi: 10.1097/MCG.0b013e318266f6cf
ALIMENTARY TRACT: Original Articles

Goals: To meta-analyze whether Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation could improve Helicobacter pylori (H. pylori) eradication rates and reduce side effects.

Background: There have been several studies demonstrating that Lactobacillus and Bifidobacterium species have an inhibitory effect on H. pylori. The application of probiotics in clinical practice is more often in the form of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation.

Study: We included all parallel controlled trials comparing Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation supplementation or not during H. pylori eradication therapy in meta-analysis. Statistical analysis was performed with the Stata version 11.0 software. Subgroup analysis and sensitivity analysis were also performed.

Results: Ten clinical trials were included in our meta-analysis. Eradication odds ratio (OR) was available for 1469 patients (708 in the probiotics supplementation group and 761 in the control group). The pooled OR by intention-to-treat analysis and by per-protocol analysis in the probiotics supplementation versus without probiotics was 2.066 [95% confidence interval (CI), 1.398-3.055] and 2.321 (95% CI, 1.715-3.142), respectively. The pooled OR of incidence of total side effects was significantly decreased in the probiotics supplementation group (OR=0.305; 95% CI, 0.117-0.793) by the random model without significant publication bias.

Conclusions: Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation during initial H. pylori eradication therapy in the adult may have beneficial effects on eradication rate and incidence of total side effects.

*Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai Institute of Digestive Disease

Key Laboratory of Gastroenterology & Hepatology, Ministry of Health (Shanghai Jiao-Tong University), Shanghai, China

Supported by the National Basic Research Program of China 973 program Grant (No.2010CB5293).

The authors declare that they have nothing to disclose.

Reprints: Jing-Yuan Fang, MD, PhD, Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai Institute of Digestive Disease; 145 Middle Shandong Rd, Shanghai 200001, China (e-mail: jingyuanfang2007@126.com).

Received February 15, 2012

Accepted June 27, 2012

© 2013 Lippincott Williams & Wilkins, Inc.