1. Evaluation of Helicobacter pylori eradication by triple therapy plus Lactobacillus acidophilus compared to triple therapy alone.
- Author
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Medeiros JA, Gonçalves TM, Boyanova L, Pereira MI, de Carvalho JN, Pereira AM, and Cabrita AM
- Subjects
- Adult, Aged, Aged, 80 and over, Amoxicillin administration & dosage, Amoxicillin therapeutic use, Breath Tests, Clarithromycin administration & dosage, Clarithromycin therapeutic use, Combined Modality Therapy, Drug Therapy, Combination, Esomeprazole administration & dosage, Female, Helicobacter Infections microbiology, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Peptic Ulcer drug therapy, Peptic Ulcer microbiology, Probiotics administration & dosage, Single-Blind Method, Treatment Outcome, Urea, Young Adult, Anti-Bacterial Agents therapeutic use, Anti-Ulcer Agents therapeutic use, Esomeprazole therapeutic use, Helicobacter Infections drug therapy, Helicobacter pylori drug effects, Lactobacillus acidophilus, Probiotics therapeutic use
- Abstract
The purpose of this study was to evaluate the influence of adding Lactobacillus acidophilus to a triple regimen for Helicobacter pylori eradication in untreated patients with peptic ulcers or ulcer-scars. This was a pre-randomized, single-blind, interventional, treatment-efficacy study with active controls and parallel-assignment, set in Coimbra, Portugal, on 62 consecutive H. pylori-positive untreated adults with peptic ulcers or ulcer-scars, diagnosed by gastroduodenoscopy, with pre-treatment direct Gram-staining and culture of gastric biopsies. The first 31 patients received esomeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg (EAC), all b.i.d., for 8 days. The remaining 31 added L. acidophilus, 5 × 10(9) organisms per capsule, 3 + 2 i.d. for 8 days (EACL). The main outcome measure was (13)C urea breath test (UBT), ≥6 weeks after completion of therapy. Successful eradication (UBT-negativity after treatment), was similar in both groups (EAC = 80.6%; EACL = 83.9%, p = 0.740) by both intention-to-treat and per-protocol analysis. The non-eradicated strains were susceptible in vitro to both antibiotics. Adding L. acidophilus to EAC triple therapy did not increase H. pylori eradication rates. Considering the cost and the burden of ingesting five extra capsules daily, supplementing the EAC therapy with L. acidophilus, at this dose, shows no benefit. Further studies with different dosages and duration of treatment, and other probiotics or probiotic combinations are required to improve eradication.
- Published
- 2011
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