Efficacy of Clostridium butyricum preparation concomitantly with Helicobacter pylori eradication therapy in relation to changes in the intestinal microbiota

Microbiol Immunol. 2008 Mar;52(3):156-61. doi: 10.1111/j.1348-0421.2008.00026.x.


Antibiotic associated diarrhea due to human intestinal microbiota abnormalities is a side effect of H. pylori eradication therapy. We examined intestinal microbiota changes during H. pylori eradication therapy and the preventive effect of CBM588 as a probiotic agent. Nineteen patients with gastro-duodenal ulcer were randomly divided into three groups: group A (without probiotics), group B (with regular doses of CBM588) and group C (with double doses of CBM588). The incidence of diarrhea and soft stools during H. pylori eradication therapy was 43% in group A and 14% in group B, while none of the patients in group C reported diarrhea or soft stools. Both bacterial counts and detection rates of bifidobacteria and/or obligate anaerobe were decreased by eradication therapy. However, bacterial counts of obligate anaerobes in group C were significantly higher than in group A (P < 0.05). Additionally, during eradication therapy C. difficile toxin A was detected in both group A and group B but not in group C. In conclusion, these results indicate that H. pylori eradication therapy induces antibiotic associated diarrhea due to abnormalities in intestinal microbiota and/or C. difficile. However, these side effects might be prevented by probiotics.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Toxins / analysis
  • Clostridium butyricum / growth & development*
  • Colony Count, Microbial
  • Diarrhea
  • Enterotoxins / analysis
  • Feces / chemistry
  • Female
  • Gastrointestinal Tract / microbiology*
  • Helicobacter Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Peptic Ulcer / drug therapy*
  • Probiotics / administration & dosage*


  • Anti-Bacterial Agents
  • Bacterial Toxins
  • Enterotoxins
  • tcdA protein, Clostridium difficile