Limosilactobacillus reuteri DSM 17938 and PTA 6475 as adjunct in Helicobacter pylori therapy: Systematic review and meta-analysis

Figure 3 Forest plot. A: Forest plot of randomized controlled trials evaluating Helicobacter pylori (H. pylori) eradication rates in patients treated with standard antibiotic therapy with or without Limosilactobacillus reuteri (L. reuteri) supplementation. The analysis includes 13 comparisons derived from 12 randomized controlled trials with a total of 368 patients in the L. reuteri plus antibiotics group and 360 patients in the antibiotics-only group; B: Forest plot of randomized controlled trials evaluating the incidence of diarrhea in patients undergoing H. pylori eradication therapy with or without L. reuteri supplementation. The analysis includes six comparisons, with one study (Poonyam et al[26]-b) excluded due to zero events in both groups. The pooled risk ratio for diarrhea was 0.34 (95% confidence interval: 0.21-0.55), indicating a statistically significant reduction in risk associated with L. reuteri supplementation. Heterogeneity across studies was negligible (I² = 0.0%; P = 0.752), supporting the consistency of this protective effect. RR: Risk ratio; CI: Confidence interval; L. reuteri: Limosilactobacillus reuteri.