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Clinical Outcomes of Standard Triple Therapy Plus Probiotics or Concomitant Therapy for Helicobacter pylori Infection

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Background/Aims: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. Methods: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. Results: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). Conclusions: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.

Abstract

Background/Aims: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. Methods: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. Results: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). Conclusions: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.

참고문헌 (42)

  1. McColl KE, "Clinical practice: Helicobacter pylori infection", N Engl J Med, 362, pp.1597~1604 (2010)[DOI]
  2. Kim SG, "Guidelines for the diagnosis and treatment of Helicobacter pylori infection in Korea, 2013 revised edition", J Gastroenterol Hepatol, 29, pp.1371~1386 (2014)[DOI]
  3. 오창모, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2013", Cancer Research and Treatment, 48(2), pp.436~450 (2016), 대한암학회
  4. Song ZQ, "Helicobacter pylori and gastric cancer: clinical aspects", Chin Med J (Engl), 128, pp.3101~3105 (2015)[DOI]
  5. Shin WG, "Eradication rates of Helicobacter pylori in Korea over the past 10 years and correlation of the amount of antibiotics use: nationwide survey", Helicobacter, 21, pp.266~278 (2016)[DOI]
  6. Megraud F, "Failed eradication for Helicobacter pylori: what should be done?", Dig Dis, 34, pp.505~509 (2016)[DOI]
  7. McFarland LV, "Systematic review and meta-analysis: multi-strain probiotics as adjunct therapy for Helicobacter pylori eradication and prevention of adverse events", United European Gastroenterol J, 4, pp.546~561 (2016)[DOI]
  8. Puig I, "Systematic review and meta-analysis: triple therapy combining a proton-pump inhibitor, amoxicillin and metronidazole for Helicobacter pylori first-line treatment", J Antimicrob Chemother, 71, pp.2740~2753 (2016)[DOI]
  9. Jung SM, "Comparing the efficacy of concomitant therapy with sequential therapy as the first-line therapy of Helicobacter pylori eradication", Gastroenterol Res Pract, 2016, pp.1293649~ (2016)
  10. Lee HJ, "Concomitant therapy achieved the best eradication rate for Helicobacter pylori among various treatment strategies", World J Gastroenterol, 21, pp.351~359 (2015)[DOI]
  11. 김수영, "10일간의 동시치료가 10일간의 순차치료보다 헬리코박터 파일로리 제균율이 우월하다", 대한소화기학회지, 64(5), pp.260~267 (2014), 대한소화기학회
  12. 김범진, "Online Registry for Nationwide Database of Current Trend of Helicobacter pylori Eradication in Korea: Interim Analysis", Journal of Korean Medical Science, 31(8), pp.1246~1253 (2016), 대한의학회
  13. 안병락, "Antibiotic Resistance in Helicobacter pylori Strains and its Effect on H. pylori Eradication Rates in a Single Center in Korea", Annals of Laboratory Medicine, 33(6), pp.415~419 (2013), 대한진단검사의학회
  14. Zandbergen D, "The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: a systematic review", BMC Oral Health, 16, pp.27~ (2016)[DOI]
  15. Kefeli A, "Comparison of three different regimens against Helicobacter pylori as a first-line treatment: a randomized clinical trial", Bosn J Basic Med Sci, 16, pp.52~57 (2016)
  16. Srinarong C, "Improved eradication rate of standard triple therapy by adding bismuth and probiotic supplement for Helicobacter pylori treatment in Thailand", Asian Pac J Cancer Prev, 15, pp.9909~9913 (2014)[DOI]
  17. Du YQ, "Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection", World J Gastroenterol, 18, pp.6302~6307 (2012)[DOI]
  18. Kim MN, "The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication", Helicobacter, 13, pp.261~268 (2008)[DOI]
  19. Gotteland M, "Suppressive effect of frequent ingestion of Lactobacillus johnsonii La1 on Helicobacter pylori colonization in asymptomatic volunteers", J Antimicrob Chemother, 51, pp.1317~1319 (2003)[DOI]
  20. Szajewska H, "Systematic review with meta-analysis: Saccharomyces boulardii supplementation and eradication of Helicobacter pylori infection", Aliment Pharmacol Ther, 41, pp.1237~1245 (2015)[DOI]
  21. Zhang MM, "Probiotics in Helicobacter pylori eradication therapy: a systematic review and meta-analysis", World J Gastroenterol, 21, pp.4345~4357 (2015)[DOI]
  22. Lu C, "Probiotic supplementation does not improve eradication rate of Helicobacter pylori infection compared to placebo based on standard therapy: a meta-analysis", Sci Rep, 6, pp.23522~ (2016)[DOI]
  23. Zhu R, "Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy", World J Gastroenterol, 20, pp.18013~18021 (2014)[DOI]
  24. Song MJ, "The effect of probiotics and mucoprotective agents on PPI-based triple therapy for eradication of Helicobacter pylori", Helicobacter, 15, pp.206~213 (2010)[DOI]
  25. Chung JW, "Ten-day empirical sequential or concomitant therapy is more effective than triple therapy for Helicobacter pylori eradication: a multicenter, prospective study", Dig Liver Dis, 48, pp.888~892 (2016)[DOI]
  26. Lim JH, "Clinical outcomes of two-week sequential and concomitant therapies for Helicobacter pylori eradication: a randomized pilot study", Helicobacter, 18, pp.180~186 (2013)[DOI]
  27. Hill C, "Expert consensus document: the International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic", Nat Rev Gastroenterol Hepatol, 11, pp.506~514 (2014)[DOI]
  28. Embleton ND, "Probiotics for prevention of necrotizing enterocolitis and sepsis in preterm infants", Curr Opin Infect Dis, 29, pp.256~261 (2016)[DOI]
  29. Ehrhardt S, "Saccharomyces boulardii to prevent antibiotic-associated diarrhea: a randomized, double-masked, placebo-controlled trial", Open Forum Infect Dis, 3, pp.ofw011~ (2016)
  30. Lichtenstein L, "Probiotics and prebiotics in Crohn's disease therapies", Best Pract Res Clin Gastroenterol, 30, pp.81~88 (2016)
  31. Kalima K, "Probiotics and respiratory and gastrointestinal tract infections in Finnish military conscripts: a randomised placebo-controlled double-blinded study", Benef Microbes, 7, pp.463~471 (2016)[DOI]
  32. Blattner CM, "Update: do probiotics prevent or treat pediatric atopic dermatitis?", Pediatr Allergy Immunol, 27, pp.425~428 (2016)
  33. Fijan S, "Microorganisms with claimed probiotic properties: an overview of recent literature", Int J Environ Res Public Health, 11, pp.4745~4767 (2014)[DOI]
  34. Zheng X, "Lactobacillus-containing probiotic supplementation increases Helicobacter pylori eradication rate: evidence from a meta-analysis", Rev Esp Enferm Dig, 105, pp.445~453 (2013)[DOI]
  35. Safavi M, "Treatment of Helicobacter pylori infection: current and future insights", World J Clin Cases, 4, pp.5~19 (2016)[DOI]
  36. Boltin D, "Probiotics in Helicobacter pylori-induced peptic ulcer disease", Best Pract Res Clin Gastroenterol, 30, pp.99~109 (2016)[DOI]
  37. Seo SI, "Is there any difference in the eradication rate of Helicobacter pylori infection according to the endoscopic stage of peptic ulcer disease?", Helicobacter, 20, pp.424~430 (2015)[DOI]
  38. Gisbert JP, "Helicobacter pylori eradication therapy is more effective in peptic ulcer than in nonulcer dyspepsia", Eur J Gastroenterol Hepatol, 13, pp.1303~1307 (2001)[DOI]
  39. Ojetti V, "Helicobacter pylori infection and diabetes", Minerva Med, 101, pp.115~119 (2010)
  40. Marietti M, "Helicobacter pylori infection and diabetes mellitus: the 2013 state of art", Panminerva Med, 55, pp.277~281 (2013)
  41. Dai YN, "Is Helicobacter pylori infection associated with glycemic control in diabetics?", World J Gastroenterol, 21, pp.5407~5416 (2015)[DOI]
  42. Tongtawee T, "High prevalence of Helicobacter pylori resistance to clarithromycin: a hospital-based cross-sectional study in Nakhon Ratchasima Province, Northeast of Thailand", Asian Pac J Cancer Prev, 16, pp.8281~8285 (2015)

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