The role of probiotics in <i>Helicobacter pylori</i> eradication therapy regimens: current evidence of eff ectiveness

Abstract

One of the most important rules of the modern approach to the treatment of H. pylori infection is to provide eradication therapy to all those infected. Unfortunately, in real clinical practice, doctors and patients often have concerns about the administration of antibiotics, their possible side eff ects and the duration of standard protocols. The increase in antibiotic resistance observed in diff erent countries is also a serious problem, which explains the need to search for alternative therapeutic options for the treatment of Helicobacter infection. In this regard, the search and analysis of the accumulated scientifi c information about the eff ects of including probiotics in the eradication therapy of H. pylori infection is of particular relevance. We have studied the available data on the effi cacy of diff erent probiotic strains in patients infected with H. pylori . Thus, to date, there is strong evidence that the use of probiotics leads to a reduction in the adhesive properties of H. pylori , reduces the degree of bacterial colonization and the severity of infl ammation of the gastric mucosa. Probiotics can be considered a useful adjuvant to standard protocols including antibiotics and proton pump inhibitors, and can be used not only to improve eradication effi cacy, but most importantly to reduce the incidence of gastrointestinal symptoms, which are a frequent cause of reduced adherence and treatment drop-out. We found support for the suggestion that multistrain probiotics are more eff ective than mono-strain probiotics in optimizing eradication therapy in adults and children.