Probiotics for the Treatment of Helicobacter Pylori Infection in Children: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 HEJi-dong , LIULi , ZHUYu-jiang

Department of Gastroenterology, Second People's Hospital of YaAn, YaAn 625000, China;

Corresponding author：

Keywords：

Helicobacter pylori; Probiotics; Children; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150233

Video：

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Objective To systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. Methods We electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. Results A total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). Conclusion Current evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.

Citation： HEJi-dong, LIULi, ZHUYu-jiang. Probiotics for the Treatment of Helicobacter Pylori Infection in Children: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(12): 1431-1436. doi: 10.7507/1672-2531.20150233 Copy

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2.	张万岱, 胡伏莲, 萧树东, 等. 中国自然人群幽门螺杆菌感染的流行病学调查. 现代消化及介入诊疗, 2010, 15(5):265-270.
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4.	Farrell S, Doherty GM, Milliken I, et al. Risk factors for Helicobacter pylori infection in children:an examination of the role played by intrafamilial bed sharing. Pediatr Infect Dis J, 2005, 24(2):149-152.
5.	Boyanova L. Prevalence of multidrug-resistant Helicobacter pylori in Bulgaria. J Med Microbiol, 2009, 58(Pt 7):930-935.
6.	Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis:the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther, 2010, 32(9):1069-1079.
7.	Dang YH, Reinhardt JD, Zhou X, et al. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy:a meta-analysis. PLoS One, 2014, 9(11):e111030.
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10.	Goldman CG, Barrado DA, Balcarce N, et al. Effect of a probiotic food as an adjuvant to triple therapy for eradication of Helicobacter pylori infection in children. Nutrition, 2006, 22(10):984-988.
11.	Lionetti E, Miniello VL, Castellaneta SP, et al. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children:a randomized placebo controlled trial. Aliment Pharmacol Ther, 2006, 24(10):1461-1468.
12.	Hurduc V, Plesca D, Dragomir D, et al. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatr, 2009, 98(1):127-131.
13.	Szajewska H, Albrecht P, Topczewska-Cabanek A. Randomized, double-blind, placebo-controlled trial:effect of lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr, 2009, 48(4):431-436.
14.	潘彤彤, 朱欢, 卢华君. 益生菌辅助三联疗法治疗儿童幽门螺杆菌感染疗效观察. 海峡药学, 2010, 22(2):109-110.
15.	张玲, 窦会娟, 赵振宇. 益生菌辅助治疗儿童幽门螺杆菌感染的疗效观察. 中国现代医药杂志, 2010, 12(11):92-93.
16.	Saneeyan H, Layegh S, Rahimi H. Effectiveness of probiotic on treatment of Helicobacter pylori infection in children. J Isfah Med Sch, 2011, 29:882-889.
17.	Tolone S, Pellino V, Vitaliti G, et al. Evaluation of Helicobacter Pylori eradication in pediatric patients by triple therapy plus lactoferrin and probiotics compared to triple therapy alone. Ital J Pediatr, 2012, 38:63.
18.	Ahmad K, Fatemeh F, Mehri N, et al. Probiotics for the treatment of pediatric helicobacter pylori infection:a randomized double blind clinical trial. Iran J Pediatr, 2013, 23(1):79-84.
19.	李墨, 周雪梅. 三联疗法联合益生菌治疗儿童幽门螺杆菌感染疗效观察. 现代中西医结合杂志, 2014, 23(26):2883-2884.
20.	赵红梅, 欧阳红娟, 段柏平, 等. 三联疗法联合布拉氏酵母菌治疗儿童幽门螺杆菌感染的临床研究. 中国当代儿科杂志, 2014, 16(3):230-233.
21.	Reid G, Jass J, Sebulsky MT, et al. Potential uses of probiotics in clinical practice. Clin Microbiol Rev, 2003, 16(4):658-672.
22.	Brzozowski T, Konturek PC, Mierzwa M, et al. Effect of probiotics and triple eradication therapy on the cyclooxygenase (COX)-2 expression, apoptosis, and functional gastric mucosal impairment in Helicobacter pylori-infected Mongolian gerbils. Helicobacter, 2006, 11(1):10-20.
23.	Myllyluoma E, Veijola L, Ahlroos T, et al. Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy——a placebo-controlled, double-blind randomized pilot study. Aliment Pharmacol Ther, 2005, 21(10):1263-1272.
24.	郭继兵, 杨蒲芳, 汪明涛, 等. 酪酸菌在幽门螺杆菌治疗中的应用. 中华腹部疾病杂志, 2004, 4(3):163-165.

1. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med, 2002, 347(15):1175-1186.
2. 张万岱, 胡伏莲, 萧树东, 等. 中国自然人群幽门螺杆菌感染的流行病学调查. 现代消化及介入诊疗, 2010, 15(5):265-270.
3. Perri F, Qasim A, Marras L, et al. Treatment of Helicobacter pylori infection. Helicobacter, 2003, 8 Suppl 1:53-60.
4. Farrell S, Doherty GM, Milliken I, et al. Risk factors for Helicobacter pylori infection in children:an examination of the role played by intrafamilial bed sharing. Pediatr Infect Dis J, 2005, 24(2):149-152.
5. Boyanova L. Prevalence of multidrug-resistant Helicobacter pylori in Bulgaria. J Med Microbiol, 2009, 58(Pt 7):930-935.
6. Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis:the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther, 2010, 32(9):1069-1079.
7. Dang YH, Reinhardt JD, Zhou X, et al. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy:a meta-analysis. PLoS One, 2014, 9(11):e111030.
8. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. Available at:http://www.cochrane-handbook.org.
9. Sýkora J, Valecková K, Amlerová J, et al. Effects of a specially designed fermented milk product containing probiotic Lactobacillus casei DN-114 001 and the eradication of H. pylori in children:a prospective randomized double-blind study. J Clin Gastroenterol, 2005, 39(8):692-698.
10. Goldman CG, Barrado DA, Balcarce N, et al. Effect of a probiotic food as an adjuvant to triple therapy for eradication of Helicobacter pylori infection in children. Nutrition, 2006, 22(10):984-988.
11. Lionetti E, Miniello VL, Castellaneta SP, et al. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children:a randomized placebo controlled trial. Aliment Pharmacol Ther, 2006, 24(10):1461-1468.
12. Hurduc V, Plesca D, Dragomir D, et al. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatr, 2009, 98(1):127-131.
13. Szajewska H, Albrecht P, Topczewska-Cabanek A. Randomized, double-blind, placebo-controlled trial:effect of lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr, 2009, 48(4):431-436.
14. 潘彤彤, 朱欢, 卢华君. 益生菌辅助三联疗法治疗儿童幽门螺杆菌感染疗效观察. 海峡药学, 2010, 22(2):109-110.
15. 张玲, 窦会娟, 赵振宇. 益生菌辅助治疗儿童幽门螺杆菌感染的疗效观察. 中国现代医药杂志, 2010, 12(11):92-93.
16. Saneeyan H, Layegh S, Rahimi H. Effectiveness of probiotic on treatment of Helicobacter pylori infection in children. J Isfah Med Sch, 2011, 29:882-889.
17. Tolone S, Pellino V, Vitaliti G, et al. Evaluation of Helicobacter Pylori eradication in pediatric patients by triple therapy plus lactoferrin and probiotics compared to triple therapy alone. Ital J Pediatr, 2012, 38:63.
18. Ahmad K, Fatemeh F, Mehri N, et al. Probiotics for the treatment of pediatric helicobacter pylori infection:a randomized double blind clinical trial. Iran J Pediatr, 2013, 23(1):79-84.
19. 李墨, 周雪梅. 三联疗法联合益生菌治疗儿童幽门螺杆菌感染疗效观察. 现代中西医结合杂志, 2014, 23(26):2883-2884.
20. 赵红梅, 欧阳红娟, 段柏平, 等. 三联疗法联合布拉氏酵母菌治疗儿童幽门螺杆菌感染的临床研究. 中国当代儿科杂志, 2014, 16(3):230-233.
21. Reid G, Jass J, Sebulsky MT, et al. Potential uses of probiotics in clinical practice. Clin Microbiol Rev, 2003, 16(4):658-672.
22. Brzozowski T, Konturek PC, Mierzwa M, et al. Effect of probiotics and triple eradication therapy on the cyclooxygenase (COX)-2 expression, apoptosis, and functional gastric mucosal impairment in Helicobacter pylori-infected Mongolian gerbils. Helicobacter, 2006, 11(1):10-20.
23. Myllyluoma E, Veijola L, Ahlroos T, et al. Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy——a placebo-controlled, double-blind randomized pilot study. Aliment Pharmacol Ther, 2005, 21(10):1263-1272.
24. 郭继兵, 杨蒲芳, 汪明涛, 等. 酪酸菌在幽门螺杆菌治疗中的应用. 中华腹部疾病杂志, 2004, 4(3):163-165.

Chinese Journal of Evidence-Based Medicine

Probiotics for the Treatment of Helicobacter Pylori Infection in Children: A Meta-analysis

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