Probiotics for the treatment of Helicobacter pylori infection in children

Table 2 Clinical trials using probiotics in the treatment of Helicobacter pylori infection in children

Ref.	Study design	Probiotic strain (product; dose; time)	Patients	Diagnosis	Eradication	Test for confirming eradication	Comments
					n (%); P value	(time after completion of therapy)
Cruchet et al[63]	DB, R	Lactobacillus johnsonii (La1), living or heat-killed, 80 mL/die, (> 107 CFU/mL) (Chamyto, Nestlé) and L. helveticus (LH) for 4 wk; Lactobacilli paracasei ST11, living or heat-killed, (> 107 CFU/mL) and LH for 4 wk	252 (aged 6-17 yr) asymptomatic children and adolescents: Living La1/LH, n = 511; Heat-killed La1/LH, n = 501; Living ST11/LH, n = 501; Heat-killed ST11/LH, n = 511; LH, n = 501	13C-UBT	A moderate but significant difference in 13C-UBT values was detected in children receiving live La1, whereas no differences were observed in the other groups	13C-UBT (at the end of treatment)
Gotteland et al[65]	R, DB, PC	Lactobacillus johnsonii La1, living or heat-killed, 80 mL/die, (> 107 CFU/mL) for 3 wk (Chamyto, Nestlé) with or without cranberry juice (CB) (200 mL)	271 (aged 6-16 yr) asymptomatic children and adolescents: CB/La1, n = 701; Placebo juice/La1, n = 671; CB/heat-killed La1, n = 651; Placebo juice/heat-killed La1 (control), n = 691	13C-UBT	16 (22.9)1 11 (16.9)1 10 (14.9)1vs 1 (1.5)1; P < 0.01	13C-UBT (a second 13C-UBT at the end of treatment and a third 13C-UBT after 1 mo)	The third UBT was carried out in only 19 of the 38 children found to be H. Pylori-negative in the second UBT: 12, 2, and 5 subjects from the CB/La1, placebo juice/La1, and CB/heat-killed La1 groups, respectively. Only four children (21) remained negative, after 1 mo without treatment: two from the placebo juice/La1 group and two from the CB/La1 group
Boonyaritichaikij et al[66]	SB, PC	Lactobacillus gasseri OLL2716 (LG21), pieces of cheese weighing 1.6-2.0 g, approximately 5 × 108 CFU/g for 1 yr	88 (aged 3-7 yr) asymptomatic children and adolescents completed the eradication arm: LG21, n = 821; ordinary cheese, n = 61 while 222 completed the prevention arm: LG21, n = 1231; Ordinary cheese, n = 991	HpSA	24 (29.3)1vs 0. In the randomized prevention arm: 5 (4.1) vs 8 (8.1); P = 0.21 were HpSA positive at 12 mo	HpSA (1 yr)	A total of 440 asymptomatic children were screened by the HpSA test. Thereafter 132 H. Pylori positive and 308 H. Pylori negative children were recruited to eradication and randomized prevention arms, respectively. Eradication was defined as reversion by HpSA at 12 mo; prevention as persistently HpSA negative at 12 mo

¹Per-protocol analysis. R: Randomized; DB: Double-Blind; SB: Single Blind; PC: Placebo Controlled; CFU: Colony Forming Units;

¹³C-UBT:Urea Breath Test; H. Pylori: Helicobacter pylori; HpSA: H. Pylori stool antigens.