Pretreatment with Lactobacillus- and Bifidobacterium-containing yogurt can improve the efficacy of quadruple therapy in eradicating residual Helicobacter pylori infection after failed triple therapy

• Published in: The American journal of clinical nutrition 2006-04, Vol.83 (4), p.864-869
• Main Authors: SHEU, Bor-Shyang, CHENG, Hsiu-Chi, KAO, Ai-Wen, WANG, Shan-Tair, YANG, Yao-Jong, YANG, Hsiao-Bai, WU, Jiunn-Jong
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Anti-Ulcer Agents - therapeutic use; Antibiosis; Bacteria; Bifidobacterium - physiology; Biological and medical sciences; Breath Tests; Carbon Isotopes; Combined Modality Therapy; Drug resistance; Drug Resistance, Bacterial; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Helicobacter Infections - diet therapy; Helicobacter Infections - drug therapy; Helicobacter Infections - therapy; Helicobacter pylori - drug effects; Helicobacter pylori - growth & development; Humans; Infections; Lactobacillus - physiology; Male; Medical treatment; Middle Aged; Patient Compliance; Probiotics - administration & dosage; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Yogurt; Yogurt - microbiology
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/83.4.864

Lactobacillus- and Bifidobacterium-containing yogurt (AB-yogurt) can suppress Helicobacter pylori. Improvement of the eradication rate by quadruple therapy of residual H. pylori after failed triple therapy is needed. We tested whether prior treatment with AB-yogurt improved the efficacy of quadruple therapy in eradicating residual H. pylori after failed triple therapy. One hundred thirty-eight patients in whom triple therapy failed were enrolled for a culture study of H. pylori to assess antimicrobial resistance. These patients were then randomly assigned in equal numbers to either a yogurt-plus-quadruple therapy group or a quadruple therapy-only group. The patients received 1 wk of quadruple therapy with or without a 4-wk pretreatment with AB-yogurt (400 mL/d). In the yogurt-plus-quadruple group, excessive delta(13)CO(2)/mL values of the (13)C-urea breath test were collected before and every 2 wk during the 4-wk ingestion of yogurt. For both groups, a (13)C-urea breath test was conducted > or =6 wk after the quadruple therapy to assess the outcome of residual H. pylori eradication. For the patients in the yogurt-plus-quadruple therapy group infected with either antibiotic-sensitive or -resistant H. pylori, the excessive delta(13)CO(2)/mL values of the (13)C-urea breath test were significantly decreased after the 4-wk ingestion of AB-yogurt (P < 0.0001). The yogurt-plus-quadruple therapy group had a higher H. pylori eradication rate than did the quadruple therapy-only group (intention-to-treat analysis: 85% compared with 71.1%, P < 0.05; per-protocol analysis: 90.8% compared with 76.6%, P < 0.05). A 4-wk pretreatment with AB-yogurt can decrease H. pylori loads despite antimicrobial resistance, thus improving the efficacy of quadruple therapy in eradicating residual H. pylori.