Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy

Table 1 Initial and rechecked Helicobacter pylori assessments, follow-up times, loss rates, and scoring systems used to assess adverse effects in the included studies

Ref.	H. pylori assessment		Follow-up time	Loss rate	Side effect scoring system
	Initial	Rechecking
Emara et al[15]	HpSA, RUT, Histology	HpSA, RUT, Histology	4 wk1	0.00%	Non-Boer
			6 wk2
Medeiros et al[16]	Culture	UBT	≥ 6 wk	0.00%	Not reported
Song et al[17]	RUT, Histology	UBT	4 wk	8.50%	Non-Boer
Du et al[18]	RUT, UBT, Pathologic examination	UBT	4 wk	2.60%	Non-Boer
Deguchi et al[19]	Culture, Histology, RUT	UBT, HpSA	8 wk	5.20%	Not reported
Mirzaee et al[20]	UBT	UBT	4 wk	16.20%	Non-Boer
Canducci et al[21]	UBT, Histology	UBT, Histology, Endoscopy	6 wk	2.50%	By de Boer et al
Nista et al[22]	UBT	UBT	6 wk	5.70%	By de Boer et al
Sheu et al[23]	Histology, RUT	UBT, Histology, RUT	4 wk1	6.90%	Non-Boer
			8 wk2
Myllyluoma et al[24]	Rapid whole blood test, UBT, EIA serology	UBT, EIA, serology	4 wk1	0.00%	By de Boer et al
			4 mo2
Yaşar et al[25]	Histology	UBT	4 wk	8.90%	Non-Boer
Kim et al[26]	RUT, Histology	UBT	4-6 wk	3.00%	Non-Boer
Scaccianoce et al[27]	Histology	UBT	4-6 wk	3.00%	Non-Boer
Cindoruk et al[28]	Histology	UBT	6 wk	0.00%	By de Boer et al

¹Probiotic group;

²Control group. EIA: Enzyme immunoassay; HpSA: H. pylori stool antigen test; RUT: Rapid urease test; UBT: C13 or C14 urea breath test.

Table 2 Numbers of experimental and context groups, and probiotic and eradication regimens

Ref.(location)	Ethnicity	Total(exp/cont)	Regimen		Jadad scores
			Probiotic	Eradication
Emara et al[15] (Egypt)	Caucasian	70 (35/35)	Lactobacillus reuteri (DSM 17938 and ATCC PTA 6475), 2 × 108 CFU qd for 4 wk	O: 20 mg	5
				A: 1000 mg
				C 500 mg
				bid for 14 d
Medeiros et al[16] (Portugal)	Caucasian	62 (31/31)	Lactobacillus acidophilus (BioSaúde laboratories, Portugal), 15 × 109 CFU, 10 × 109 CFU qn for 8 d	E: 20 mg	2
				A: 1000 mg
				C: 500 mg
				bid for 8 d
Song et al[17] (Korea)	Asian	661 (330/331)	Saccharomyces boulardii (Bioflor250, Kuhnil Pharmacy, Seoul, Korea), 3 × 1010 CFU tid for 4 wk	O: 20 mg	3
				A: 1000 mg
				C: 500 mg
				bid for 7 d
Du et al[18] (China)	Asian	156 (77/79)	Lactobacillus acidophilus, 107 CFU, Streptococcus faecalis, 5 × 106 CFU, Bacillus subtilis, 104 CFU tid for 2 wk	O: 20 mg	3
				A: 1000 mg
				C: 500 mg
				bid for 7d
Deguchi et al[19] (Japan)	Asian	229 (115/114)	Lactobacillus gasseri (OLL2716), ≥ 109 CFU bid for 4 wk	R: 10 mg	3
				A: 750 mg
				C: 200 mg
				bid for 7 d
Mirzaee et al[20] (Iran)	Caucasian	68 (34/34)	Probiotic yogurt (1.5% fat), 150 mg bid for 7 d	P: 40 mg qd	2
				A: 1000 mg bid
				C: 500 mg bid
				for 7 d
Canducci et al[21] (Italy)	Caucasian	120 (60/60)	Lactobacillus acidophilus strain LB, ≥ 5 × 109 heat-killed organisms tid for 10 d	R: 20 mg bid	3
				C: 250 mg tid
				A: 500 mg tid
				for 7d
Nista et al[22] (Italy)	Caucasian	106 (54/52)	Bacillus clausii (Sanofi-Synthelabo OTC, Milan, Italy), 2 × 109 CFU tid for 14 d	R: 20 mg	4
				A: 1000 mg
				C: 500 mg
				bid for 7d
Sheu et al[23] (Taiwan)	Asian	160 (80/80)	Bifidobacterium-containing yogurt, ≥ 5 × 109 live organisms per bottle bid for 4 wk	L: 30 mg	2
				A: 1000 mg
				C: 500 mg
				bid for 7 d
Myllyluoma et al[24] (Finland)	Caucasian	47 (23/24)	Probiotics (Valio Ltd, Helsinki, Finland), 65 × 109 CFU bid for 1 wk 65 × 109 CFU qd for 3 wk	L: 30 mg	4
				C: 500 mg
				A: 1000 mg
				bid for 7d
Yaşar et al[25] (Turkey)	Caucasian	76 (38/38)	Bifidobacterium (DN-173 010-10), 1010 CFU qd for 14 d	P: 40 mg	2
				A: 1000 mg
				C: 500 mg
				bid for 14 d
Kim et al[26] (Korea)	Asian	347 (168/179)	Lactobacillus acidophilus (HY 2177), > 15 × 106 CFU, L. casei (HY 2743), > 15 × 106 CFU, B. longum (HY 8001), > 15 × 107 CFU, S. thermophilus (B-1), > 15 × 109 CFU qd for 3 wk	Standard PPI	2
				C: 500 mg
				A: 1000 mg
				bid for 7d
Scaccianoce et al[27] (Italy)	Caucasian	33 (17/16)	Lactobacillus reuteri (ATCC 55730), 108 CFU bid for 7 d		1
				L: 30 mg
				A: 1000 mg
				C: 500 mg
Cindoruk et al[28] (Turkey)	Caucasian	124 (62/62)	Saccharomyces boulardii, 1 gram (250 mg sachets, 500 mg bid Reflor (Sanofi-Synthelabo Ilac A.S., Istanbul, Turkey) bid for 2 wk	bid for 7d	4
				L: 30 mg
				A: 1000 mg
				C: 500 mg
				bid for 14 d

A: Amoxicillin; C: Clarithromycin; cont: Control; CFU: Colony forming units; E: Esomeprazole; exp: Experimental; L: Lansoprazole; O: Omeprazole; P: Pantoprazole; PPI: Proton pump inhibitor; R: Rabeprazole.