Lactobacillus reuteri in the treatment of Helicobacter pylori infection

Probiotics have proven to be useful in the treatment of a number of gastrointestinal diseases. Probiotics may compete directly with Helicobacter pylori , possibly by interference with adherence or by the production of antimicrobial molecules. Lactobacillus reuteri has been shown to inhibit H . pylor...

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Bibliographic Details
Published in:Internal and emergency medicine 2014-09, Vol.9 (6), p.649-654
Main Authors: Dore, Maria Pina, Cuccu, Marianna, Pes, Gianni Mario, Manca, Alessandra, Graham, David Yates
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Helicobacter Infections - therapy
Helicobacter pylori
Humans
Im - Original
Internal Medicine
Lactobacillus reuteri
Male
Medicine
Medicine & Public Health
Middle Aged
Pilot Projects
Probiotics - therapeutic use
Prospective Studies
Young Adult
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Summary:Probiotics have proven to be useful in the treatment of a number of gastrointestinal diseases. Probiotics may compete directly with Helicobacter pylori , possibly by interference with adherence or by the production of antimicrobial molecules. Lactobacillus reuteri has been shown to inhibit H . pylori in vitro and in vivo, and theoretically may play a role in eradication therapy. The aim of this study was to examine the efficacy of L. reuteri in H . pylori eradication therapy. This was an open label single center study. H . pylori infection was defined as positive gastric histopathology and 13 C-UBT. Intervention consisted of L . reuteri (DSM 17938) 10 8  cfu plus pantoprazole 20 mg twice a day for 8 weeks. Eradication was defined as a negative 13 C-UBT, 4–6 weeks post therapy. Compliance was considered good if at least 90 % of the total number of the pills were taken. 21 of 22 subjects completed the study without protocol violation (mean age 52 years; 36 % men). L . reuteri plus pantoprazole twice a day cured 13.6 % (3/22; 95 % CI 2.9–34.9 %) of patients with H . pylori infection by ITT analysis and 14.2 % (3/21; 95 % CI 3.0–36 %) by PP analysis. Overall urease activity assessed before and 4–6 weeks post therapy showed a significant reduction with a difference of mean of 38.8 vs. 25.4 by one-tailed test ( P  = 0.002). In conclusion, L . reuteri may have a potential role in H . pylori eradication therapy if the cure rate can be improved by changes in dose, dosing interval, or duration of therapy.
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-013-1013-z