Association of a probiotic to a Helicobacter pylori eradication regimen does not increase efficacy or decreases the adverse effects of the treatment: a prospective, randomized, double-blind, placebo-controlled study.
Background: The treatment for the eradication of Helicobacter pylori (H. pylori) is complex; full effectiveness is rarely achieved and it has many adverse effects. In developing countries, increased resistance to antibiotics and its cost make eradication more difficult. Probiotics can reduce adverse...
| Publicado en: | BMC Gastroenterology Vol. 13; no. 1; pp. 56 - 57 |
|---|---|
| Autores principales: | , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
BioMed Central
2013
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104225408&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104225408 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1471230X 1CHO jtl: BMC Gastroenterology issn: 1471230X maglogo: N pubinfo: dt: 2013 vid: 13 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 104225408 104225408 NLM23530767 2012261280 10.1186/1471-230X-13-56 NLM23530767 PMC3614530 104225408 ppf: 56 ppct: 1 formats: tig: atl: Association of a probiotic to a Helicobacter pylori eradication regimen does not increase efficacy or decreases the adverse effects of the treatment: a prospective, randomized, double-blind, placebo-controlled study. aug: au: Navarro-Rodriguez, Tomás Silva, Fernando Marcuz Barbuti, Ricardo Correa Mattar, Rejane Moraes-Filho, Joaquim Prado de Oliveira, Maricê Nogueira Bogsan, Cristina S Chinzon, Décio Eisig, Jaime Natan affil: Serviço de Gastroenterologia Clínica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, Av, Dr, Enéas de Carvalho Aguiar, 255 - Cerqueira Cezar, Sao Paulo, SP, Brasil. tomasnavarro@uol.com.br. sug: subj: Antibiotics Adverse Effects Antibiotics Therapeutic Use Disease Outbreaks Prevention and Control Helicobacter Infections Drug Therapy Helicobacter Infections Prevention and Control Helicobacter Pylori Probiotics Therapeutic Use Brazil Double-Blind Studies Dyspepsia Drug Therapy Dyspepsia Microbiology Female Human Male Middle Age Nitrofurans Adverse Effects Nitrofurans Therapeutic Use Peptic Ulcer Drug Therapy Peptic Ulcer Microbiology Prospective Studies Proton Pump Inhibitors Adverse Effects Proton Pump Inhibitors Therapeutic Use Sulfur Compounds Adverse Effects Sulfur Compounds Therapeutic Use Tetracycline Adverse Effects Tetracycline Therapeutic Use Treatment Outcomes Middle Aged: 45-64 years Female Male ab: Background: The treatment for the eradication of Helicobacter pylori (H. pylori) is complex; full effectiveness is rarely achieved and it has many adverse effects. In developing countries, increased resistance to antibiotics and its cost make eradication more difficult. Probiotics can reduce adverse effects and improve the infection treatment efficacy.If the first-line therapy fails a second-line treatment using tetracycline, furazolidone and proton-pump inhibitors has been effective and low cost in Brazil; however it implies in a lot of adverse effects. The aim of this study was to minimize the adverse effects and increase the eradication rate applying the association of a probiotic compound to second-line therapy regimen.Methods: Patients with peptic ulcer or functional dyspepsia infected by H. pylori were randomized to treatment with the furazolidone, tetracycline and lansoprazole regimen, twice a day for 7 days. In a double-blind study, patients received placebo or a probiotic compound (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum and Streptococcus faecium) in capsules, twice a day for 30 days. A symptom questionnaire was administered in day zero, after completion of antibiotic therapy, after the probiotic use and eight weeks after the end of the treatment. Upper digestive endoscopy, histological assessment, rapid urease test and breath test were performed before and eight weeks after eradication treatment.Results: One hundred and seven patients were enrolled: 21 men with active probiotic and 19 with placebo plus 34 women with active probiotic and 33 with placebo comprising a total of 55 patients with active probiotic and 52 with placebo. Fifty-one patients had peptic ulcer and 56 were diagnosed as functional dyspepsia. The per-protocol eradication rate with active probiotic was 89.8% and with placebo, 85.1% (p=0.49); per intention to treat, 81.8% and 79.6%, respectively (p=0.53). The rate of adverse effects at 7 days with the active probiotic was 59.3% and 71.2% with placebo (p=0.20). At 30 days, it was 44.9% and 60.4%, respectively (p=0.08).Conclusions: The use of this probiotic compound compared to placebo in the proposed regimen in Brazilian patients with peptic ulcer or functional dyspepsia showed no significant difference in efficacy or adverse effects.Trial Registration: Current Controlled Trials ISRCTN04714018. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|