Effect of Pretreatment with Lactobacillus gasseri OLL2716 on First-line Helicobacter pylori Eradication Therapy
Journal of Gastroenterology and Hepatology, 04/20/2012
Deguchi R et al. – The study confirmed that the major cause of treatment failure is resistance to clarithromycin. A 4–week treatment with L. gasseri–containing yogurt improves the efficacy of triple therapy in patients with H. pylori infection.Methods
- Two hundred and twenty-nine patients were randomized either to a 1-week triple therapy of rabeprazole (10 mg bid), amoxicillin (750 mg bid), and clarithromycin (200mg bid) or triple therapy plus L.gasseri-containing yogurt.
- In the yogurt-plus-triple therapy groups yogurt containing L. gasseri OLL2716 (112 g) was given twice daily for 4 weeks (3- week pretreatment and also 1 week during eradication therapy).
- Clarithromycin resistance was determined by the detection of a mutation in 23S rRNA using nested PCR and the direct sequencing of DNA from pretreatment feces.
- H. pylori eradication was diagnosed based on the UBT and a stool antigen test after 8 weeks of eradication.
- The status of H. pylori susceptibility to clarithromycin was successively determined in 188 out of 229 samples.
- The rate of infection with clarithromycin-resistant strains of H. pylori was 27.1%.
- Overall eradication (intention to treat/ per protocol) was 69.3/74.5 % for the triple-only group, and 82.6/85.6 % for the yogurt-plus-triple group (p = 0.018/p = 0.041).
- Eradication of primary clarithromycin-resistant strains tended to be higher for yogurt-plus-triple therapy than triple-only therapy. (38.5 vs. 28.0%, respectively, p = 0.458).