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Lactobacillus reuteri in the treatment of Helicobacter pylori infection

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Abstract

Probiotics have proven to be useful in the treatment of a number of gastrointestinal diseases. Probiotics may compete directly with Helicobacter pylori, possibly by interference with adherence or by the production of antimicrobial molecules. Lactobacillus reuteri has been shown to inhibit H. pylori in vitro and in vivo, and theoretically may play a role in eradication therapy. The aim of this study was to examine the efficacy of L. reuteri in H. pylori eradication therapy. This was an open label single center study. H. pylori infection was defined as positive gastric histopathology and 13C-UBT. Intervention consisted of L. reuteri (DSM 17938) 108 cfu plus pantoprazole 20 mg twice a day for 8 weeks. Eradication was defined as a negative 13C-UBT, 4–6 weeks post therapy. Compliance was considered good if at least 90 % of the total number of the pills were taken. 21 of 22 subjects completed the study without protocol violation (mean age 52 years; 36 % men). L. reuteri plus pantoprazole twice a day cured 13.6 % (3/22; 95 % CI 2.9–34.9 %) of patients with H. pylori infection by ITT analysis and 14.2 % (3/21; 95 % CI 3.0–36 %) by PP analysis. Overall urease activity assessed before and 4–6 weeks post therapy showed a significant reduction with a difference of mean of 38.8 vs. 25.4 by one-tailed test (P = 0.002). In conclusion, L. reuteri may have a potential role in H. pylori eradication therapy if the cure rate can be improved by changes in dose, dosing interval, or duration of therapy.

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Authors and Affiliations

  1. Dipartimento di Medicina Clinica e Sperimentale, Clinica Medica, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy

    Maria Pina Dore, Marianna Cuccu, Gianni Mario Pes & Alessandra Manca

  2. Baylor College of Medicine, Houston, TX, USA

    Maria Pina Dore & David Yates Graham

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  1. Maria Pina Dore
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  2. Marianna Cuccu
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  3. Gianni Mario Pes
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  4. Alessandra Manca
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Correspondence to Maria Pina Dore.

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Dore, M.P., Cuccu, M., Pes, G.M. et al. Lactobacillus reuteri in the treatment of Helicobacter pylori infection. Intern Emerg Med 9, 649–654 (2014). https://doi.org/10.1007/s11739-013-1013-z

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  • DOI: https://doi.org/10.1007/s11739-013-1013-z

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