Departement of Internal Medicine, Catholic University of Rome, 00168 Rome, Italy.
Gastroenterol Res Pract. 2012;2012:740381. doi: 10.1155/2012/740381. Epub 2012 May 29.
Introduction. Helicobacter pylori eradication therapy has the potential burden of antibiotic-associated gastrointestinal (GI) side effects. The occurrence of side effects is among the major drawbacks of such regimens. GI manifestations may be related to alterations in the intestinal microflora. Probiotics can prevent or reduce antibiotic-associated side effects and have an inhibitory effect on H. pylori. Methods. To define the efficacy of Lactobacillus reuteri supplementation in H. pylori eradication and in preventing GI-associated side effects during a second-line levofloxacin triple therapy. 90 H. pylori-positive patients receive for 7 days a second-line triple therapy with esomeprazole, levofloxacin, and amoxicillin with L. reuteri for 14 days (group 1) and without probiotic supplementation (group 2). Each subject received a validated questionnaire to record symptoms everyday for 4 weeks from the start of therapy. H. pylori status and side effects were assessed 6 weeks after treatment. Results. The eradication rate was significantly influenced by probiotic supplementation with L. reuteri (group 1: 36/45, 80%; group 2: 28/45 62%; P < 0.05). The incidence of nausea and diarrhoea in group 1 was significantly lower than that in group 2. Conclusion. In H. pylori-positive subjects L. reuteri supplementation increases the eradication rate while reducing the incidence of the most common side effects associated with antibiotic therapy in second-line treatment.
简介。幽门螺杆菌根除疗法可能会带来抗生素相关的胃肠道（GI）副作用负担。副作用的发生是此类方案的主要缺点之一。GI 表现可能与肠道菌群的改变有关。益生菌可预防或减少抗生素相关的副作用，并对幽门螺杆菌具有抑制作用。方法。为了确定补充罗伊氏乳杆菌在幽门螺杆菌根除和预防二线左氧氟沙星三联疗法中与 GI 相关副作用的疗效。90 例幽门螺杆菌阳性患者接受埃索美拉唑、左氧氟沙星和阿莫西林的二线三联疗法 7 天，并同时补充罗伊氏乳杆菌 14 天（第 1 组）或不补充益生菌（第 2 组）。每位受试者在治疗开始后 4 周内每天使用经过验证的问卷记录症状。治疗 6 周后评估幽门螺杆菌状态和副作用。结果。补充罗伊氏乳杆菌显著影响根除率（第 1 组：45 例中有 36 例，80%；第 2 组：45 例中有 28 例，62%；P<0.05）。第 1 组恶心和腹泻的发生率明显低于第 2 组。结论。在幽门螺杆菌阳性患者中，补充罗伊氏乳杆菌可提高根除率，同时降低二线治疗中抗生素治疗最常见副作用的发生率。
