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Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis.
Eur J Clin Pharmacol. 2017 Oct; 73(10):1199-1208.EJ

Abstract

AIM

The aim of this study was to identify the best probiotic supplementation in triple therapy for pediatric population with Helicobacter pylori infection.

METHODS

Eligible trials were identified by comprehensive searches. Relative risks with 95% confidence intervals and relative ranks with P scores were assessed.

RESULTS

Twenty-nine trials (3122 participants) involving 17 probiotic regimens were identified. Compared with placebo, probiotic-supplemented triple therapy significantly increased H. pylori eradication rates (relative ratio (RR) 1.19, 95% CI 1.13-1.25) and reduced the incidence of total side effects (RR 0.49, 95% CI 0.38-0.65). Furthermore, to supplemented triple therapy, Lactobacillus casei was identified the best for H. pylori eradication rates (P score = 0.84), and multi-strain of Lactobacillus acidophilus and Lactobacillus rhamnosus for total side effects (P score = 0.93). As for the subtypes of side effects, multi-strain of Bifidobacterium infantis, Bifidobacterium longum, L. acidophilus, L. casei, Lactobacillus plantarum, Lactobacillus reuteri, L. rhamnosus, Lactobacillus salivarius, Lactobacillus sporogenes, and Streptococcus thermophilus was the best to reduce the incidence of diarrhea; multi-strain of Bacillus mesentericus, Clostridium butyricum, and Streptococcus faecalis for loss of appetite; multi-strain of B. longum, Lactobacillus bulgaricus, and S. thermophilus for constipation; multi-strain of Bifidobacterium bifidum, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. reuteri, and Streptococcus for taste disturbance; Saccharomyces boulardii for bloating; and multi-strain of Bifidobacterium breve, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. rhamnosus, and S. thermophilus for nausea/vomiting.

CONCLUSIONS

Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation.

Authors+Show Affiliations

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China.Department of Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA, 98115, USA.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Department of Gastroenterology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Zhaoqiu@medmail.com.cn. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. Zhaoqiu@medmail.com.cn.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. lili234510@126.com. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, No. 169, Donghu Road, Wuchang District, Wuhan, Hubei Province, 430071, China. lili234510@126.com.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

28681177

Citation

Feng, Jue-Rong, et al. "Efficacy and Safety of Probiotic-supplemented Triple Therapy for Eradication of Helicobacter Pylori in Children: a Systematic Review and Network Meta-analysis." European Journal of Clinical Pharmacology, vol. 73, no. 10, 2017, pp. 1199-1208.
Feng JR, Wang F, Qiu X, et al. Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis. Eur J Clin Pharmacol. 2017;73(10):1199-1208.
Feng, J. R., Wang, F., Qiu, X., McFarland, L. V., Chen, P. F., Zhou, R., Liu, J., Zhao, Q., & Li, J. (2017). Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis. European Journal of Clinical Pharmacology, 73(10), 1199-1208. https://doi.org/10.1007/s00228-017-2291-6
Feng JR, et al. Efficacy and Safety of Probiotic-supplemented Triple Therapy for Eradication of Helicobacter Pylori in Children: a Systematic Review and Network Meta-analysis. Eur J Clin Pharmacol. 2017;73(10):1199-1208. PubMed PMID: 28681177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis. AU - Feng,Jue-Rong, AU - Wang,Fan, AU - Qiu,Xiao, AU - McFarland,Lynne V, AU - Chen,Peng-Fei, AU - Zhou,Rui, AU - Liu,Jing, AU - Zhao,Qiu, AU - Li,Jin, Y1 - 2017/07/05/ PY - 2017/03/08/received PY - 2017/06/14/accepted PY - 2017/7/7/pubmed PY - 2018/7/7/medline PY - 2017/7/7/entrez KW - Children KW - Efficacy KW - Helicobacter pylori KW - Network meta-analysis KW - Probiotics KW - Safety SP - 1199 EP - 1208 JF - European journal of clinical pharmacology JO - Eur J Clin Pharmacol VL - 73 IS - 10 N2 - AIM: The aim of this study was to identify the best probiotic supplementation in triple therapy for pediatric population with Helicobacter pylori infection. METHODS: Eligible trials were identified by comprehensive searches. Relative risks with 95% confidence intervals and relative ranks with P scores were assessed. RESULTS: Twenty-nine trials (3122 participants) involving 17 probiotic regimens were identified. Compared with placebo, probiotic-supplemented triple therapy significantly increased H. pylori eradication rates (relative ratio (RR) 1.19, 95% CI 1.13-1.25) and reduced the incidence of total side effects (RR 0.49, 95% CI 0.38-0.65). Furthermore, to supplemented triple therapy, Lactobacillus casei was identified the best for H. pylori eradication rates (P score = 0.84), and multi-strain of Lactobacillus acidophilus and Lactobacillus rhamnosus for total side effects (P score = 0.93). As for the subtypes of side effects, multi-strain of Bifidobacterium infantis, Bifidobacterium longum, L. acidophilus, L. casei, Lactobacillus plantarum, Lactobacillus reuteri, L. rhamnosus, Lactobacillus salivarius, Lactobacillus sporogenes, and Streptococcus thermophilus was the best to reduce the incidence of diarrhea; multi-strain of Bacillus mesentericus, Clostridium butyricum, and Streptococcus faecalis for loss of appetite; multi-strain of B. longum, Lactobacillus bulgaricus, and S. thermophilus for constipation; multi-strain of Bifidobacterium bifidum, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. reuteri, and Streptococcus for taste disturbance; Saccharomyces boulardii for bloating; and multi-strain of Bifidobacterium breve, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. rhamnosus, and S. thermophilus for nausea/vomiting. CONCLUSIONS: Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation. SN - 1432-1041 UR - https://www.unboundmedicine.com/medline/citation/28681177/Efficacy_and_safety_of_probiotic_supplemented_triple_therapy_for_eradication_of_Helicobacter_pylori_in_children:_a_systematic_review_and_network_meta_analysis_ L2 - https://dx.doi.org/10.1007/s00228-017-2291-6 DB - PRIME DP - Unbound Medicine ER -