Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
, 13, 56

Association of a Probiotic to a Helicobacter Pylori Eradication Regimen Does Not Increase Efficacy or Decreases the Adverse Effects of the Treatment: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Randomized Controlled Trial

Association of a Probiotic to a Helicobacter Pylori Eradication Regimen Does Not Increase Efficacy or Decreases the Adverse Effects of the Treatment: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Tomás Navarro-Rodriguez et al. BMC Gastroenterol.


Background: The treatment for the eradication of Helicobacter pylori (H. pylori) is complex; full effectiveness is rarely achieved and it has many adverse effects. In developing countries, increased resistance to antibiotics and its cost make eradication more difficult. Probiotics can reduce adverse effects and improve the infection treatment efficacy.If the first-line therapy fails a second-line treatment using tetracycline, furazolidone and proton-pump inhibitors has been effective and low cost in Brazil; however it implies in a lot of adverse effects. The aim of this study was to minimize the adverse effects and increase the eradication rate applying the association of a probiotic compound to second-line therapy regimen.

Methods: Patients with peptic ulcer or functional dyspepsia infected by H. pylori were randomized to treatment with the furazolidone, tetracycline and lansoprazole regimen, twice a day for 7 days. In a double-blind study, patients received placebo or a probiotic compound (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum and Streptococcus faecium) in capsules, twice a day for 30 days. A symptom questionnaire was administered in day zero, after completion of antibiotic therapy, after the probiotic use and eight weeks after the end of the treatment. Upper digestive endoscopy, histological assessment, rapid urease test and breath test were performed before and eight weeks after eradication treatment.

Results: One hundred and seven patients were enrolled: 21 men with active probiotic and 19 with placebo plus 34 women with active probiotic and 33 with placebo comprising a total of 55 patients with active probiotic and 52 with placebo. Fifty-one patients had peptic ulcer and 56 were diagnosed as functional dyspepsia. The per-protocol eradication rate with active probiotic was 89.8% and with placebo, 85.1% (p=0.49); per intention to treat, 81.8% and 79.6%, respectively (p=0.53). The rate of adverse effects at 7 days with the active probiotic was 59.3% and 71.2% with placebo (p=0.20). At 30 days, it was 44.9% and 60.4%, respectively (p=0.08).

Conclusions: The use of this probiotic compound compared to placebo in the proposed regimen in Brazilian patients with peptic ulcer or functional dyspepsia showed no significant difference in efficacy or adverse effects.

Trial registration: Current Controlled Trials ISRCTN04714018.


Figure 1
Figure 1
Symptom Questionnaire. Absent: without symptom; Mild: symptom doesn’t interfere with normal activity; Moderate: symptom interferes with normal activity < 50% of evaluated time; Severe: Symptom interferes with normal activity > 50% of evaluated time, or daily, or determines the treatment interruption.
Figure 2
Figure 2
Probiotic Flow Diagram.

Similar articles

See all similar articles

Cited by 21 PubMed Central articles

See all "Cited by" articles


    1. Coelho LG, Zaterka S. [Second Brazilian Consensus Conference on Helicobacter pylori infection] Arq Gastroenterol. 2005;42:128–132. - PubMed
    1. Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102:1808–1825. doi: 10.1111/j.1572-0241.2007.01393.x. - DOI - PubMed
    1. Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, El-Omar EM, Kuipers EJ. Management of Helicobacter pylori infection–the Maastricht IV/ Florence Consensus Report. Gut. 2012;61:646–664. doi: 10.1136/gutjnl-2012-302084. - DOI - PubMed
    1. Talley NJ, Fock KM, Moayyedi P. Gastric Cancer Consensus conference recommends Helicobacter pylori screening and treatment in asymptomatic persons from high-risk populations to prevent gastric cancer. Am J Gastroenterol. 2008;103:510–514. doi: 10.1111/j.1572-0241.2008.01819.x. - DOI - PubMed
    1. Gasparetto M, Pescarin M, Guariso G. Helicobacter pylori Eradication Therapy: Current Availabilities. ISRN Gastroenterol. 2012;2012:186734. - PMC - PubMed

Publication types

MeSH terms

Associated data