The Efficacy of Saccharomyces boulardii CNCM I-745 in Addition to Standard Helicobacter pylori Eradication Treatment in Children
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Purpose: This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children. Methods: One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omepra-zole+clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and com-pliance to the eradication treatment were compared. A 13C urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate. Results: In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after 6.25±1.24 days, lasting 3.17±1.08 days, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after 4.05±1.11 days, lasting 4.02±0.87 days, and in six cases eradication treatment was stopped prematurely (p＜0.05). The 13C urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant). Conclusion: S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treat-ment was improved.
Abstract
Purpose: This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children. Methods: One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omepra-zole+clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and com-pliance to the eradication treatment were compared. A 13C urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate. Results: In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after 6.25±1.24 days, lasting 3.17±1.08 days, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after 4.05±1.11 days, lasting 4.02±0.87 days, and in six cases eradication treatment was stopped prematurely (p＜0.05). The 13C urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant). Conclusion: S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treat-ment was improved.
참고문헌 (24)
- Jafri W, "Helicobacter pylori infection in children: population-based age-specific prevalence and risk factors in a developing country", Acta Paediatr, 99, pp.279~282 (2010)
- Yang XQ, "Pediatrics", pp.295~296 (2003), People's Medical Publishing House
- Ng SC, "Mechanisms of action of probiotics: recent advances", Inflamm Bowel Dis, 15, pp.300~310 (2009)
- Preidis GA, "Targeting the human microbiome with antibiotics, probiotics, and prebiotics: gastroenterology enters the metagenomics era", Gastroenterology, 136, pp.2015~2031 (2009)
- Koletzko S, "Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children", J Pediatr Gastroenterol Nutr, 53, pp.230~243 (2011)
- Wallace JL, "Proton pump inhibitors exacerbate NSAID-induced small intestinal injury by inducing dysbiosis", Gastroenterology, 141, pp.1314~1322 (2011)
- Higuchi K, "Efficacy and safety of Helicobacter pylori eradication therapy with omeprazole, amoxicillin and high- and low-dose clarithromycin in Japanese patients: a randomised, double-blind, multicentre study", Clin Drug Investig, 26, pp.403~414 (2006)
- Hurduc V, "A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children", Acta Paediatr, 98, pp.127~131 (2009)
- Szajewska H, "Meta-analysis:the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment", Aliment Pharmacol Ther, 32, pp.1069~1079 (2010)
- Swidsinski A, "Biostructure of fecal microbiota in healthy subjects and patients with chronic idiopathic diarrhea", Gastroenterology, 135, pp.568~579 (2008)
- Barc MC, "Molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment: influence of Saccharomyces boulardii", Anaerobe, 14, pp.229~233 (2008)
- McFarland LV, "Systematic review and meta-analysis of Saccharomyces boulardii in adult patients", World J Gastroenterol, 16, pp.2202~2222 (2010)
- Vandenplas Y, "Saccharomyces boulardii in childhood", Eur J Pediatr, 168, pp.53~65 (2009)
- Cadamuro AC, "Helicobacter pylori infection: host immune response, implications on gene expression and microRNAs", World J Gastroenterol, 20, pp.1424~1437 (2014)
- Beswick EJ, "H. pylori and host interactions that influence pathogenesis", World J Gastroenterol, 12, pp.5599~5605 (2006)
- Abdel-Latif MM, "Helicobacter pylori extract induces nuclear factor-kappa B, activator protein-1, and cyclooxygenase-2 in esophageal epithelial cells", J Gastrointest Surg, 10, pp.551~562 (2006)
- Lopes AI, "Cytokine expression in pediatric Helicobacter pylori infection", Clin Diagn Lab Immunol, 12, pp.994~1002 (2005)
- Chen X, "Saccharomyces boulardii inhibits ERK1", 2 mitogen-activated protein kinase activation both in vitro and in vivo and protects against Clostridium difficile toxin A-induced enteritis, 2006, pp.281, 24449~24454
- Dalmasso G, "Saccharomyces boulardii inhibits inflammatory bowel disease by trapping T cells in mesenteric lymph nodes", Gastroenterology, 131, pp.812~825 (2006)
- Thomas S, "Saccharomyces boulardii inhibits lipopolysaccharide-induced activation of human dendritic cells and T cell proliferation", Clin Exp Immunol, 156, pp.78~87 (2009)
- Fidan I, "Effects of Saccharomyces boulardii on cytokine secretion from intraepithelial lymphocytes infected by Escherichia coli and Candida albicans", Mycoses, 52, pp.29~34 (2009)
- Gotteland M, "Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus LB in children colonized by Helicobacter pylori", Acta Paediatr, 94, pp.747~751 (2005)
- Dupont C, "Anti-diarrheal effects of diosmectite in the treatment of acute diarrhea in children:a review", Paediatr Drugs, 11, pp.89~99 (2009)
- Guarino A, "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition", European Society for Pediatric Infectious Diseases evidencebased guidelines for the management of acute gastroenteritis in children in Europe: update 20, 2014, pp.59, 32~52