Abstract

PINTO, Cristiana Sousa; ALVES, Patrícia  and  FRASCO, Joana. The effect of probiotics on helicobacter pylori eradication: an evidence-based review. Rev Port Med Geral Fam [online]. 2019, vol.35, n.5, pp.392-400. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i5.12291.

Introduction: Helicobacter pylori (H. pylori) infection is an important risk factor for several gastric diseases, including peptic ulcer, chronic atrophic gastritis and gastric cancer, and so its eradication is the main therapeutic goal. Probiotics can help to achieve this goal, and equally play a positive role in reducing the side effects of the treatment. Objetive: To determine the effect of probiotics as an adjuvant therapy for H. pylori eradication in adults. Data sources: MEDLINE and evidence-based medicine sites. Revision methods: A research of meta-analyses (MA), systematic reviews (SR), randomised controlled trials (RCTs) and clinical practice guidelines (CPG) was performed using the MeSH terms ‘Helicobacter pylori’ and ‘Probiotics’. The research was limited to articles published between January 2006 and July 2016, in English and Portuguese. The Strength of Recommendation Taxonomy was used to assign the level of evidence and the strength of recommendation. Results: A total of 61 articles was found; amongst these, two MAs, two RSs, five RCTs and three CPGs met the inclusion criteria and were therefore selected. MAs present mixed results: one showed higherr eradication rates with probiotic treatment; the other did not demonstrate superiority of probiotics when compared with placebo. Both showed its beneficial effect in reducing side effects. In spite of showing a positive effect of probiotics on adverse effects, the two SRs did not show benefit of their use for the eradication of H. pylori. All RCTs showed higher bacterial eradication rates in the group treated with probiotics. CPGs suggest the use of probiotics in the treatment of H. pylori eradication. Conclusions: Adding probiotics to the treatment regimen used for H. pylori eradication may be beneficial since it seems to be associated with higher eradication rates (strength of recommendation B) and less adverse effects (strength of recommendation A).

Keywords : Helicobacter pylori; Probiotics.

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