Efficacy of standard triple therapy combined with probiotics for Helicobacter pylori infection in duodenal ulcer

Objective To evaluate the efficacy of standard triple therapy combined with probiotics for Helicobacter pylori (H. pylori) infection in duodenal ulcer. Methods Two hundred and twenty five patients with H. pylori-infected duodenal ulcer were randomly assigned to receive the treatment with standard triple therapy (triple group, n=75), quadruple therapy (colloidal bismuth subcitrate combined with standard triple therapy) (quadruple group, n=75) or probiotics combined with standard triple therapy (bifidobacterium and lactobacillus combined with standard triple therapy) (probiotics group, n=75) for 14 days. The gastroscopy and 13C urea breath test were performed in all patients and the adverse reactions were observed 4 weeks after treatment. Results The healing rate of duodenal ulcer in probiotics group was significantly higher than those in triple and quadruple groups (80.8% vs. 46.15%, 80.80% vs. 63.49%; P=0.000, 0.024, respectively). With intention to treat analysis, the H. pylori eradication rate in probiotics group was 85.33%, which was significantly higher than that in triple group (61.33%, P=0.001) and in quadruple group (72.00%, P=0.046). With per-protocol analysis, the H. pylori eradication rates were 85.71% in probiotics group and 87.67% in quadruple group (P=0.737), but both were higher than that in triple group(70.77%; P=0.014, 0.041, respectively). The incidence of adverse reactions including constipation, taste distortion and bloating in probiotics group was significantly lower than those in the other two groups. Conclusions Bifidobacterium and lactobacillus triple live bacteria combined with standard triple therapy can increases the H. pylori eradication rate and duodenal ulcer healing rate with high compliance and low adverse reactions in patients with H. pylori-infected duodenal ulcer. Key words: Helicobacter pylori; Therapy; Probiotics