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Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection.

Abstract

BACKGROUND

Probiotics have never been used as second-line treatment in patients resistant to a first course of anti-H. pylori treatment.

MATERIAL/METHODS

70 consecutive patients with persistent H. pylori infection were enrolled and treated with ranitidine bismuth citrate (RBC) 400 mg b.d, esomeprazole or pantoprazole 40 mg/day, amoxycillin 1 g t.d, tinidazole 500 mg b.d. with (group A) or witlhout (group B) supplementation with 750 mg daily containing 16 billion bacteria Lactobacillus casei subsp. casei DG. Esomeprazole or pantoprazole 40 mg/day was administered for a further 4 weeks in cases of active peptic ulcer or severe gastritis detected at endoscopy. In these cases endoscopy was repeated one month after conclusion of therapy. The remaining patients were checked by 13C-urea breath test.

RESULTS

Sixty-six patients completed the study, 34 in group A and 32 in group B. One group A patient (2.85%) was excluded for protocol violation and one group B patient (2.85%) was lost to follow-up. 33/34 group A patients were H. pylori-negative [per-protocol: 97.05%, on intention-to-treat: 94.28%]. 5/34 patients (14.7%) showed side-effects, but all of them completed the treatment. In group B, two patients (5.71%) showed severe side-effects and were withdrawn from the study. 30/32 patients were H. pylori-negative [per-protocol: 93.75%, on intention-to-treat: 85.71% (p = n.s.)]. 11/32 patients (34.37%) showed side-effects, but all of them completed the study (p < 0.05).

CONCLUSIONS

This 10-day quadruple therapy obtains a high eradication rate, but probiotic supplementation reduces side-effects and permits a slight improvement in eradicating H. pylori.

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  • Authors+Show Affiliations

    ,

    Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria (BA), Italy. antotursi@tiscali.it

    , ,

    Source

    MeSH

    Adult
    Aged
    Anti-Bacterial Agents
    Anti-Ulcer Agents
    Drug Therapy, Combination
    Female
    Gastrointestinal Diseases
    Helicobacter Infections
    Helicobacter pylori
    Humans
    Lactobacillus casei
    Male
    Middle Aged
    Probiotics
    Treatment Failure

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    15567983

    Citation

    Tursi, Antonio, et al. "Effect of Lactobacillus Casei Supplementation On the Effectiveness and Tolerability of a New Second-line 10-day Quadruple Therapy After Failure of a First Attempt to Cure Helicobacter Pylori Infection." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 10, no. 12, 2004, pp. CR662-6.
    Tursi A, Brandimarte G, Giorgetti GM, et al. Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Med Sci Monit. 2004;10(12):CR662-6.
    Tursi, A., Brandimarte, G., Giorgetti, G. M., & Modeo, M. E. (2004). Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 10(12), pp. CR662-6.
    Tursi A, et al. Effect of Lactobacillus Casei Supplementation On the Effectiveness and Tolerability of a New Second-line 10-day Quadruple Therapy After Failure of a First Attempt to Cure Helicobacter Pylori Infection. Med Sci Monit. 2004;10(12):CR662-6. PubMed PMID: 15567983.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. AU - Tursi,Antonio, AU - Brandimarte,Giovanni, AU - Giorgetti,Gian Marco, AU - Modeo,Maria Ester, PY - 2004/01/09/received PY - 2004/01/19/accepted PY - 2004/11/30/pubmed PY - 2005/6/2/medline PY - 2004/11/30/entrez SP - CR662 EP - 6 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med. Sci. Monit. VL - 10 IS - 12 N2 - BACKGROUND: Probiotics have never been used as second-line treatment in patients resistant to a first course of anti-H. pylori treatment. MATERIAL/METHODS: 70 consecutive patients with persistent H. pylori infection were enrolled and treated with ranitidine bismuth citrate (RBC) 400 mg b.d, esomeprazole or pantoprazole 40 mg/day, amoxycillin 1 g t.d, tinidazole 500 mg b.d. with (group A) or witlhout (group B) supplementation with 750 mg daily containing 16 billion bacteria Lactobacillus casei subsp. casei DG. Esomeprazole or pantoprazole 40 mg/day was administered for a further 4 weeks in cases of active peptic ulcer or severe gastritis detected at endoscopy. In these cases endoscopy was repeated one month after conclusion of therapy. The remaining patients were checked by 13C-urea breath test. RESULTS: Sixty-six patients completed the study, 34 in group A and 32 in group B. One group A patient (2.85%) was excluded for protocol violation and one group B patient (2.85%) was lost to follow-up. 33/34 group A patients were H. pylori-negative [per-protocol: 97.05%, on intention-to-treat: 94.28%]. 5/34 patients (14.7%) showed side-effects, but all of them completed the treatment. In group B, two patients (5.71%) showed severe side-effects and were withdrawn from the study. 30/32 patients were H. pylori-negative [per-protocol: 93.75%, on intention-to-treat: 85.71% (p = n.s.)]. 11/32 patients (34.37%) showed side-effects, but all of them completed the study (p < 0.05). CONCLUSIONS: This 10-day quadruple therapy obtains a high eradication rate, but probiotic supplementation reduces side-effects and permits a slight improvement in eradicating H. pylori. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/15567983/full_citation L2 - https://www.medscimonit.com/download/index/idArt/13232 DB - PRIME DP - Unbound Medicine ER -