Probiotics for the Treatment of Pediatric HelicobacterPyloriInfection: A Randomized Double Blind Clinical Trial

Abstract

Objective:Helicobacterpylori is recognized as a major etiological factor in the pathogenesis of gastritis and peptic ulcer disease. H. Pylorieradication has a failure rate of more than 30% in pediatric patients, particularly because of poor compliance, antibiotic resistance and occurrence of side-effects. This study was aimed to determine whether adding the probiotics to a standard anti-H.pyloriregimen could minimize the gastrointestinal side-effect prevalence and improve the eradication rate. Methods: Double-blind randomized placebo controlled study conducted at Childrens Medical Center in Tehran, Iran. Sixty six H. pyloripositive children were treated with a triple drug treatment protocol (omeprazole+amoxycillin+furazolidon) and randomly allocated to receive either probiotic or placebo. All patients underwent esophagogastroduodendoscopy.H.pylori infection was diagnosed by either rapid urease test (RUT) or histology. H.pyloristatus was assessed after 4-8 weeks of the completion of treatment with stoolH.pylori antigen test. The side effects of the treatment were determined in each group. Findings:Mean age of patients was 9.09 (range 3‐14) years, 44 (65.7%) patients were boys (sex ratio 2:1). All 66 patients completed the course of treatment and follow-up. The rate of H. pylorieradication was significantly higher in probiotic group (P=0.04). In probiotic supplemented children there was a lower rate of nausea/vomiting (P=0.02) and diarrhea (P=0.039) during treatment. Conclusion:This study showed that probiotics have positive effect on the eradication ofH.pyloriinfection. Adjuvant therapy with probiotic is recommended in order to reduce the frequency of antibiotic induced sideeffects during treatment with antibiotics.