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©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Jan 21, 2014; 20(3): 724-737
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.724
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.724
Table 1 Studies comparing “fermented milk based probiotic preparation” with placebo or “standard therapy + fermented milk based probiotic preparation” with “standard therapy”
| Ref. | Type of trial | Evidence grade1 | Quality rating2 | Subjects | Study design | Study groups/methods | Outcome variable/s | Results and conclusions |
| Positive | ||||||||
| Bekar et al[15], 2011, Turkey | Human | 1+ | + | 82 pts of dyspepsia and H. pylori infection | RCT | Two groups - Control group (n = 36; Triple therapy - lansoprazole, clarithromycin and amoxicillin + placebo) and Treatment group [n = 46; Triple therapy + kefir (fermented milk drink containing probiotics)]; given for 14 d | Eradication of H. pylori; adverse events of eradication therapy (Urease test after 45 d of treatment) | Significantly more patients (78.2% vs 50.0%) in the treatment group achieved eradication in comparison with control group. Side effects were less frequent and less severe in the treatment group |
| Sachdeva et al[14] 2009, India | Metaanalysis | 1+ | ++ | 10 eligible trials; data available for 963 patients | Metaanalysis of human RCTs/CCTs | Trials had to be randomized or quasi-randomized and controlled, using a FMPP in the intervention group treating Helicobacter-infected patients. The only difference between the two groups had to be FMPP | Eradication of H. pylori; adverse events of eradication therapy | The pooled odds ratio for eradication by ITT analysis in the treatment vs control group was 1.91 (1.38-2.67; P < 0.0001) using fixed effect model The pooled risk difference was 0.10 (95%CI: 0.05-0.15; P < 0.0001) by fixed effect model. Fermented milk based probiotic preparations improve H. pylori eradication rates by approximately 5%-15%, whereas the effect on adverse effects is heterogeneous |
| Sýkora et al[16], 2005, Czech Republic and United Kingdom | Human | 1+ | ++ | 86 symptomatic H. pylori positive children | RCT | Two groups - OAC-LC group - Omeprazole, amoxicillin and clarithromycin for 7 d with fermented milk containing L. casei DN-114001 for 14 d (n = 39) vs OAC group - Omeprazole, amoxicillin and clarithromycin for 7 d (n = 47) | Eradication of H. pylori, Endoscopic and Histologic comparison | ITT based eradication rates for the group A were 84.6% and 91.6% by PP analysis. Eradication in the group B was 57.5% in the ITT and 61.3% in the PP group. Eradication success was higher in the group A compared to group B in both ITT (P = 0.0045) and PP analysis (P = 0.0019) |
| Sheu et al[17], 2006, Taiwan | Human | 1+ | + | 138 patients in whom triple therapy failed | RCT | Two groups - yogurt (containing L. acidophilus La5, Lactobacillus bulgaricus, Bifidobacterium lactis Bb12 and Streptococcus thermophilus)-plus-quadruple therapy group for 7 d (n = 69) vs quadruple therapy only group (n = 69) for 7 d | Successful eradication of H. pylori, drug compliance, side effects | The yogurt-plus-quadruple therapy group had a higher H. pylori eradication rate than did the quadruple therapy only group (ITT analysis 85% vs 71.1%, P < 0.05; PP analysis- 90.8% vs 76.6%, P < 0.05). Side effects were more frequent in the quadruple therapy-only group than in the yogurt-plus-quadruple therapy group |
| Miki et al[20], 2007, Japan | Human | 1- | ++ | 69 subjects who were positive for H. pylori infection | RCT | Two groups - Fermented milk (Bifidobacterium bifidum YIT) (BF-1) (n = 34) vs placebo (untreated milk) (n = 35) for 12 wk | Suppressive effect of BF-1 fermented milk on H. pylori urease activity and gastric situation | H. pylori infection was judged by the C-UBT. H. pylori-negativity (below 5%: n = 6 and 4 in the BF-1 and placebo groups, respectively) subjects |
| Sheu et al[18], 2002, Taiwan | Human | 1- | + | 160 H. pylori infected patients | CCT | Two groups - triple plus yogurt (TYG) (containing L. acidophilus La5, Lactobacillus bulgaricus, Bifidobacterium lactis Bb12 and Streptococcus thermophilus) group (n = 80) vs triple only group (TG) (n = 80) for 7 d | Successful eradication of H. pylori, drug compliance, side effects | By ITT analysis, the triple-plus-yogurt group had a higher H. pylori eradication rate than the triple-only group (P < 0.05) and side effects were more commonly found in the TG than in the TYG. Also a significantly higher proportion of patients in the TYG completed the 7-d regimen than in the TG (67.5% vs 43.8%, P < 0.05) |
| Felley et al[21], 2001, Boston | Human | 1- | + | 53 volunteers infected with H. pylori | CCT | Two groups - Acidified milk containing L. johnsonii La1 (LC-1) (n = 25) vs Placebo (pasteurized milk) (n = 27) for 3 wk followed by 500 mg bid clarithromycin received by all subjects during the last 2 wk | Effect of the given treatment on H. pylori density, gastric inflammation and activity | In the LC-1 group, four had higher scores in the antrum, 14 were found to have a decreased H. pylori density reflected by lower scores (P = 0.02) and in the placebo group in antrum scores remain identical in 10 volunteers and decreased in 11 (0.08). The results suggest that H. pylori infection and gastritis can be down-regulated by LC-1 |
| Cats et al[22], 2003, Netherlands | Human | 1- | - | 14 H. pylori positive subjects | CCT | Two groups - Fermented milk (L.casei) for 3 wk (n = 14) vs control group (n = 6) | Effect of L.casei on urease activity in vivo (H. pylori positive subjects) | Urease activity decreased in nine of the 14 (64%) subjects with L. casei supplementation and in two of the six (33%) controls (P = 0.22). A slight, but non-significant, trend towards a suppressive effect of L. casei on H. pylori in vivo may exist |
| Wang et al[19], 2004, Taiwan | Human | 1- | - | 70 volunteers infected with H. pylori | CCT | Two groups - AB yogurt (containing L. acidophilus La5, Lactobacillus bulgaricus, Bifidobacterium lactis Bb12 and Streptococcus thermophilus) (n = 59) vs milk placebo (n = 11) for 6 wk | Effect of yogurt on H. pylori infection in humans | Administration of AB-yogurt decreased the urease activity of H. pylori after 6 wk of therapy (P < 0.0001). Regular intake of yogurt containing Bb12 and La5 effectively suppressed H. pylori infections in humans |
| Park et al[23], 2001, South Korea | Human | NR | - | 40 H. pylori infected volunteers | CCT | Two groups - Fermented milk (Lactobacillus acidophilus, Lactobacilus casei) (n = 21) vs Placebo (n = 19) for 4 wk | Eradication of H. pylori, Comparison of endoscopic findings, Compliance | All patients were compliant and the H. pylori density of antrum tended to decrease in treatment group compared with placebo group (P = 0.072). 3 cases in treatment group were noted for negative conversions of both rapid urease test and C-UBT |
| Kim et al[24], 2007, South Korea | Human | FTNA | FTNA | 262 H. pylori infected patients | CCT | Two groups - triple plus yogurt group for 3 wk (n = 147) vs triple only group (n = 115) for 1 wk | Eradication of H. pylori | In PP analysis, H. pylori eradication rate in the yogurt group, 87.7% was marginally higher than that in control group, 78.4% (P = 0.055). And according to ITT analysis, the eradication rate in the yogurt group, 78.2% was also marginally higher than that of control group, 69.5% (P = 0.062) |
| Negative | ||||||||
| Goldman et al[25], 2006, Argentina | Human | 1+ | ++ | 65 children who tested positive for H. pylori | RCT | Two groups - triple therapy with probiotic food (commercial yogurt containing Bifidobacterium animalis and Lactobacillus casei) (n = 33) vs triple therapy with placebo (milk fluid) (n = 32) | Eradication of H. pylori | We found no significant differences in H. pylori eradication rates at 1 and 3 mo between the treated group (ER 45.5% and 42.4%) and the control group (ER = 37.5% and 40.6%). Study could not demonstrate an adjuvant effect of the studied probiotic food to triple therapy in the eradication of H. pylori infection in children |
| Song et al[26], 2005, South Korea | Human | NA | - | 70 patients with duodenal ulcer | CCT | Two groups - triple-plus-fermented milk (Lactobacilli) (n = 35) vs triple plus placebo (n = 35) | H. pylori eradication rate, Fermented milk group reduces treatment-related adverse reactions | Eradication was successful in 88.6% in the Lactobacilli group and 85.7% in the placebo group (P = 1.00). Lactobacillus containing fermented milk couldn’t exert beneficial effects on H. pylori eradication or treatment-related adverse reactions |
Table 2 Studies comparing capsule based probiotic (bacteria only) with placebo or standard therapy plus capsule based probiotic vs standard therapy
| Ref. | Type of trial | Evidence grade1 | Quality rating2 | Subjects | Study design | Study groups/ methods | Outcome variable/s | Results and conclusions |
| Positive | ||||||||
| Canducci et al[27], Italy, 2000 | Human | 1+ | + | 120 H. pylori positive patients | RCT | Two groups: RCA (Rabeprazole, Clarithromycin, Amoxycillin) group- triple therapy (n = 60), RCAL group- triple therapy with Lactéol Fort for 7 d | Effect of L. acidophilus could improve the efficacy of a standard anti-H. pylori therapy | In RCA group eradication was successful in 72% at PP analysis or 70% at ITT analysis and in RCAL group eradication was achieved with 88% with PP analysis, 87% with ITT analysis |
| Negative | ||||||||
| Gotteland et al[28], 2005 | Human | 1+ | + | 254 children positive for H. pylori | RCT | Three groups: Antibiotics (group Ab)- (n = 57) for 8 d, Lactobacillus acidophilus LB (group Ab)- (n = 63) for 8 wk, Saccharomyces boulardii plus inulin (group Sb1)- (n = 62) 8 wk | To evaluate the capacity of Lactobacillus acidophilus LB and of symbiotic combination of Sb plus inulin to interfere with H. pylori colonization in children | H. pylori was eradicated in 66%, 12% and 6.5% of the children from the Ab, Sb1 and LB groups, respectively. A moderate but significant difference in ∆ DOB was detected in children receiving living Sb1, but not in those receiving LB |
| Lionetti et al[29], 2006, Italy | Human | 1+ | ++ | 40 H. pylori positive children | RCT | Two groups: Group A- 10 d sequential therapy plus L. reuteri ATCC 55730, Group B-Placebo with the same therapy | Effect of Lactobacillus reuteri to prevent or minimize the gastrointestinal side-effects | No significant differences were observed between the groups in the success of H. pylori eradication. Treatment was successful in 17 of 20 [85% (95%CI: 68-100)] patients in probiotic supplemented when compared with 16 of 20 patients in placebo group [80% (95%CI: 61–99)] (P = NS) |
| Nista et al[30], 2004, Italy | Human | 1+ | ++ | 106 H. pylori positive patients | RCT | Two groups: Group A- triple therapy for 7 d plus Bacillus clausii (probiotic) for 14 d starting from the first day of the treatment (n = 54) Group B- triple therapy plus placebo (n = 52) | Effect of probiotic on incidence and severity of antibiotic-associated side-effects during anti- H. pylori therapy and eradication was evaluated with means of 13C-urea breath test | The H. pylori eradication rate was similar between B. B. clausii and placebo groups. In particular, ITT analysis has shown H. pylori was eradicated in 39 of 54 patients (72.2%) in the B. clausii group and in 37 of 52 patients (71.15%) in the placebo group. In PP population, H. pylori was eradicated in 39 of 50 patients (78%) in the B. clausii group and in 37 of 50 patients (74%) in the placebo group |
| Myllyluoma et al[31], 2005, Finland | Human | 1+ | + | 47 subjects with H. pylori infection | CCT | Two groups: Group A –probiotic drink (n = 23), group B- Placebo (n = 24) during H. pylori eradication and for 3 wk following the treatment | Effect of probiotic therapy on symptoms associated with the recommended H. pylori eradication treatment. As a secondary end-point to find out whether this therapy could improve the eradication rate | The H. pylori eradication rate was non-significantly higher in the group receiving probiotic therapy (91% vs 79%, P = 0.42) |
| Cindoruk et al[32], 2007, Turkey | Human | 1+ | + | 124 patients with H. pylori infection | RCT | Two groups: Group A- triple therapy plus S. boulardii, Group B- triple therapy plus placebo for 14 d | Efficacy and safety of S. boulardii in the prevention of side effects and the eradication success of anti-H. pylori therapy | H. pylori eradication rate, although higher in the treatment group, was statistically similar in treatment and control groups: 71% (44/62) vs 59.7% (37/62), respectively (P > 0.05) |
| Armuzzi et al[33], 2001, Italy | Human | 1+ | + | 60 healthy asymptomatic subjects screened positive for H. pylori infection | CCT | Two groups: Group A- triple therapy for 7 d plus Lactobacillus GG for 14 d during and the week after eradication therapy, Group B- triple therapy plus placebo | Effect of probiotic Lactobacillus GG to minimize or to prevent the occurrence of gastrointestinal side effects | H. pylori eradication rates in group A was 83.33% (25/30) and in group B was 80% (24/30). H. pylori eradication rate had no significant difference |
| Guo et al[34], China, 2004 | Human | FT NA | FT NA | 97 H. pylori positive symptomatic patients | CCT | Two groups: treatment group (triple therapy plus Bifid triple viable capsule containing Bifidobacteria longum, faecal streptococci, Lactobacillus acidophilus) (n = 47) control group: triple therapy (n = 50) | Efficacy of probiotic in the treatment of H. pylori | Eradication rate was 93.6% (44/47) in treatment group and 88% in control group (44/50). H. pylori eradication rate had no significant difference |
| Armuzzi et al[35], 2001, Italy | Human | FT NA | FT NA | 120 healthy asymptomatic subjects screened positive for H. pylori infection | CCT | Two groups: Group A- triple therapy for 7 d plus Lactobacillus GG for 14 d during and the week after eradication therapy, Group B- triple therapy plus placebo | Effect of probiotic Lactobacillus GG to minimize or to prevent the occurrence of gastrointestinal side effects. | H. pylori eradication rates in group A was 80% (48/60) and in group B was 76.67% (46/60). H. pylori eradication rate had no significant difference |
| Cremonini et al[36], Italy, 2002 | Human | FT NA | FT NA | 85 H. pylori positive, asymptomatic patients | CCT | Four groups- received both during and for 7 d after a 1 wk-triple therapy Group I- Lactobacillus GG (n = 21), group II-Saccharomyces boulardii (n = 22), group III-lactobacillus spp. And bifidobacteria (n = 21), group IV-placebo (n = 21) | Efficacy of probiotic in the eradication of H. pylori infection | The H. pylori eradication rate was almost identical between the probiotic and placebo groups |
| Tursi et al[37], 2004, Italy | Human | FT NA | FT NA | 70 patients with persistent H. pylori infection | CCT | Two groups- group A- quadruple therapy plus bacteria lactobacillus casei subsp. casei DG or group B- quadruple therapy only | Effect of probiotic supplementation on the effectiveness and tolerability of a new second-line 10 d quadruple therapy | H. pylori was negative in 33/34 group A patients (PP: 97.05% ITT: 94.28%) and 30/32 Group B patients |
| Cao et al[38], China, 2005 | Human | FT NA | FT NA | 128 H. pylori positive symptomatic patients | CCT | Two groups: Group A -quadruple therapy plus Clostridium butyricum group B- quadruple therapy | Effect of treatment given in eradication of H. pylori | Eradication rates in group A 96.88% (62/64) and group B 92.19% (59/64) was not significantly different |
Table 3 Clinical trials comparing fermented milk based probiotic preparations vs plain fermented milk
| Ref. | Type of trial | Evidence grade1 | Quality rating2 | Subjects | Study design | Study groups/ methods | Outcome variable/s | Results and conclusions | |
| Positive | |||||||||
| Pantoflickova et al[39], 2003, Switzerland | Human | 1- | ++ | 50 H. pylori positive healthy volunteers | RCT | Two groups- fermented milk with LC (n = 25) vs fermented milk as Placebo (n = 25). Subjects took the treatment twice daily during the first 3 wk and once daily for the next 13 wk | Effect of LC1 intake without antibiotics on H. pylori gastritis, H. pylori density | LC1 intake had a favorable, albeit weak, effect on H. pylori associated gastritis, particularly in the antrum. Regular ingestion of fermented milk containing L.johnsonii may reduce the risk of developing disorders associated with high degrees of gastric inflammation and mucus depletion | Placebo intake led to a decrease in severity and activity of gastritis in the antrum (inflammatory cell score after 3-wk and 16 wk consumption: 6.3 ± 0.7 and 6.4 ± 1.0, respectively). In the placebo group, mucus depletion scores remained at the same level during the whole duration of the study. H. pylori density decreased in 38% of subjects after 3 wk and 50% after 16 wk |
| Horie et al[40], 2004, Japan, South Korea, Egypt | Human | 1- | - | 42 subjects with H. pylori infection | CCT | Two groups- A- test group (yogurt containing 1, 5 g of egg yolk IgY-urease 3 times daily) (n = 22), B- control group (IgY-urease free yogurt) (n = 20) | Effect of IgY-Urease drinking yogurt on C-UBT values | TG showed a reduction in UBT values from 51.18 ± 3.40 at wk 0 to 33.70 ± 3.50 and 31.03 ± 3.54 at 2 and 4 wk resp. Suppression of H. pylori infection in humans could be achieved by consumption of drinking yogurt fortified with IgY-urease | CG showed some decrease in UBT values from 51.40 ± 4.48 to 44.38 ± 5.17 and 43.53 ± 5.48 at 0, 2 and 4 wk, resp. There was no significant difference obtained at week 0 and weeks 2 or 4 |
| Sakamoto et al[41], 2001, Japan | Human | 2- | 31 subjects infected with H. pylori infection | CT | The study was conducted in two parts. 1st part = 90 g of yogurt (0-9 wk). 2nd part = 90 g yogurt containing LG21 (9-18 wk) | Efficacy of Lactobacillus gasseri OLL2716 (LG21) as a probiotic for Helicobacter pylori | The [13C] urea breath test and assays of serum pepsinogens revealed a significant improvement following LG21 treatment. LG21 was thus determined to be effective in both suppressing H. pylori and reducing gastric mucosal inflammation | There was no significant difference in C-UBT levels at 0 (26.2 ± 15.1) and 9 (26.6 ± 13.7) wk | |
Table 4 Whey protein components and its basic properties
| Whey components | Concentration (g/L) | % of Whey Protein | Molecular weight (kDa) | Number of amino acids residues | Biological properties | Recommendation grade against Helicobacter1 |
| β-Lactoglobulin | 1.3 | 50%-55% | 18277 | 162 | Source of essential and branched chain amino acids | - |
| α-Lactalbumin | 1.2 | 20%-25% | 14175 | 123 | Primary protein found in human breast milk | D |
| Source of essential and branched chain amino acids | ||||||
| Immunoglobulins(A, B and C) | 0.7 | 10%-15% | 25000 (light chain) + 50000-70000 (heavy chain) | - | Primary protein found in colostrum Immune modulating benefits | D |
| Lactoferrin | 0.1 | 1%-2% | 80000 | 700 | Antioxidant | A |
| Antibacterial, antiviral, and antifungal | ||||||
| Promotes growth of beneficial bacteria | ||||||
| Naturally occurs in breast milk, tears, saliva, bile, blood, and mucus | ||||||
| Lactoperoxidase | 0.03 | 0.50% | 70000 | 612 | Inhibits growth of bacteria | - |
| Bovine Serum Albumin | 0.4 | 5%-10% | 66267 | 582 | Source of essential amino acids | - |
| Large protein | ||||||
| Glycomacropeptide | 1.2 | 10%-15% | 6700 | 64 | Source of branched chain amino acids | D |
| Lacks the aromatic amino acids phenylalanine, tryptophan and tyrosine |
Table 5 Studies comparing bovine lactoferrin with placebo or “standard therapy + bovine lactoferrin” with “standard therapy”
| Ref. | Type of trial | Evidence grade1 | Quality rating2 | Subjects | Study design | Study groups | Outcome variable | Results and conclusion |
| Sachdeva et al[58], 2009, India | Metaanalysis | 1+ | ++ | 5 trials; 682 subjects [bLF group (n = 316); control group (n = 366)] | Metaanalysis of human RCTs/CCTs | Trials had to be randomized or quasi-randomized and controlled, using bLF in the intervention group treating Helicobacter-infected patients. The only difference between the two groups had to be bLF | Eradication of H. pylori; adverse events of eradication therapy | The pooled odds ratio (5-studies) for eradication by intention to treat analysis was 2.22 (95%CI: 1.44-3.44; P = 0.0003) using the fixed effects model (FEM) and 2.24 (95%CI: 1.15-4.35; P = 0.0003) using the random effects model (REM) (Cochran’s Q = 6.83; P = 0.145). The pooled risk difference was 0.11 (95%CI: 0.05 -0.16; P = 0.0001) by FEM (Cochran’s Q = 6.67; P = 0.154) and 0.10 (95%CI: 0.04-0.17; P = 0.0023) by REM. There was no significant difference in incidence of adverse effects |
| Di Mario et al[51], 2003, Italy | Human | 1+ | + | 150 consecutiveH. pylori-positive patients suffering from dyspeptic symptoms, gastritis and peptic ulcer disease | RCT | Three groups – A-triple therapy (rabeprazole,clarithromycin,tinidazole) with lactoferrin for 7 d (n = 51), B-triple therapy for 7 d (n = 52), C- triple therapy for 10 d (n = 47) | Efficacy of standard triple therapy plus bovine lactoferrin in the eradication of H. pylori | Eradication rates (ITT) were A- 92.2%, B-71.2%, C-70.2 %. Results suggest that lactoferrin tested in the present study was effective in curing H. pylori and could be a new agent to assist the antimicrobials in the eradication of the bacterium |
| Di Mario et al[52], 2006, Italy | Human | 1+ | + | 402 consecutiveH. pylori-positive patients suffering from dyspeptic symptoms, gastritis and peptic ulcer disease | RCT | Three groups – A- triple therapy (esomeprazole,clarithromycin,tinidazole) for 7 d (n = 136), B-lactoferrin followed by triple therapy for 7 d (n = 132), C- triple therapy with lactoferrin (n = 134) | Efficacy of bovine lactoferrin in the treatment of H. pylori infection | Eradication rate (ITT)- A- 77%, B- 73%, C = 90%. Incidence of side effects was A- 9.5%, B- 9%, C- 8.2%Results demonstrate that bovine lactoferrin is an effective adjuvant to triple therapy for eradication of H. pylori Infection |
| Okuda et al[53], 2005, Japan | Human | 1- | + | 59 H. pylori infected healthy volunteers or children who were enrolled in a previous epidemiological study | CCT | Two groups- bLF (n = 31), placebo (n = 28) | Efficacy of a single administration of bLF. Improvement of H. pylori infection, adverse effects | Positive response (> 50% decrease in C-UBT values) was observed in 10 of 31 bLF-treated subjects and 1 of 28 control subjects, indicating that the rate of positive response in the bLF group was significantly higher than that in the control group |
| Tursi et al[54], 2007, Italy | Human | 1- | + | 70 consecutive patients with persistent H. pylori infection after failure of a first standard treatment | CCT | Two groups- A-quadruple therapy (ranitidine bismuth citrate plus triple therapy- esomeprazole ,amoxicillin, tinidazole) (n = 35), B- quadruple therapy plus lactoferrin (n = 35) | Efficacy and tolerability of bLF supplementation to this quadruple therapy in re-treating H. pylori infection | Eradication rate- A-88.57%, B-94.28%. Side effects- A-29.41%, B-17.64%. bLF supplementation was found effective in reducing side-effect incidence. It seems capable of achieving a slight (NS statistically) improvement in eradicating H. pylori |
| Zullo et al[55], 2005, Italy | Human | 1+ | ++ | 133 consecutive patients with non-ulcer dyspepsia and H. pylori infection | RCT | Two groups- A- triple therapy for 7 d (n = 68), B- quadruple therapy (triple therapy plus lactoferrin) (n = 65) | Eradication rate of H. pylori infection, side effects and compliance | Eradication rate (ITT) A- 77.9%, B- 76.9%. Side effects- A –10.3%, B- 9.2%. Quadruple therapy with bLF did not significantly increase the H. pylori cure rate of standard 7-d clarithromycin-amoxycillin based triple therapy in non-ulcer dyspepsia patients |
| Zullo et al[56], 2007, Italy | Human | 1+ | + | 144 consecutive dyspeptic patients | RCT | Two groups – A- triple therapy (rabeprazole, levofoxacin, amoxycillin) (n = 72), B- quadruple therapy (rabeprazole, clarithromycin, tinidazole plus bovine lactoferrin) (n = 72) | Eradication rate of H. pylori infection, side effects and compliance | Eradication rate (ITT) A- 68.1%, B-72.2%. H. pylori eradication rate following both quadruple therapy with lactoferrin and a low-dose PPI, triple therapy with levofloxacin is disappointingly low |
| Imoto et al[57], 2004 | Human | FTNA | FTNA | 25 H. pylori positive healthy volunteers | CCT | Two groups- A- bLf mixed with a commercial yogurt (n = 16) B- yogurt (n = 9) | Effect of bLf against H. pylori | The C-UBT values at week 8 were significantly lower than those at week 0 in the bLf group (P < 0.01), whereas no difference was observed in the control group |
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Citation: Sachdeva A, Rawat S, Nagpal J. Efficacy of fermented milk and whey proteins in
Helicobacter pylori eradication: A review. World J Gastroenterol 2014; 20(3): 724-737 - URL: https://www.wjgnet.com/1007-9327/full/v20/i3/724.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i3.724