Probiotics for the Treatment of Pediatric Helicobacter Pylori Infection: A Randomized Double Blind Clinical Trial
2013
Objective: Helicobacter pylori is recognized as a major etiological
factor in the pathogenesis of gastritis and peptic ulcer disease. H.
Pylori eradication has a failure rate of more than 30% in pediatric
patients, particularly because of poor compliance, antibiotic
resistance and occurrence of side-effects. This study was aimed to
determine whether adding the probiotics to a standard anti-H. Pylori
regimen could minimize the gastrointestinal side-effect prevalence and
improve the eradication rate. Methods: Double-blind randomized placebo
controlled study conducted at Children’s Medical Center in
Tehran, Iran. Sixty six H. Pylori positive children were treated with a
triple drug treatment protocol (omeprazole+amoxycillin+furazolidon) and
randomly allocated to receive either probiotic or placebo. All patients
underwent esophagogastroduodendoscopy. H. Pylori infection was
diagnosed by either rapid urease test (RUT) or histology. H. Pylori
status was assessed after 4-8 weeks of the completion of treatment with
stool H. Pylori antigen test. The side effects of the treatment were
determined in each group. Findings:. Mean age of patients was 9.09
(range 3‐14) years, 44 (65.7%) patients were boys (sex ratio
2:1). All 66 patients completed the course of treatment and follow-up.
The rate of H. Pylori eradication was significantly higher in probiotic
group (P=0.04). In probiotic supplemented children there was a lower
rate of nausea/vomiting (P=0.02) and diarrhea (P=0.039) during
treatment. Conclusion: This study showed that probiotics have positive
effect on the eradication of H. Pylori infection. Adjuvant therapy with
probiotic is recommended in order to reduce the frequency of antibiotic
induced sideeffects during treatment with antibiotics.
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