Meta-Analysis
Copyright ©The Author(s) 2015.
World J Gastroenterol. Apr 14, 2015; 21(14): 4345-4357
Published online Apr 14, 2015. doi: 10.3748/wjg.v21.i14.4345
Table 1 Baseline characteristic of studies included in the systematic review and meta-analysis
StudyPatients (n)Age (yr)Methods of diagnosisMethods of assessmentProbiotic regimensEradication therapy regimens and dosage (mg/d)1
Navarro-Rodriguez et al[39], 2013107AdultsUBT + HA + Giemsa + RUTUBT + HA + Giemsa + RUTLacto + Bifido + Strep400F + 60La/60M + 1000Te
Ahmad et al[40], 201366ChildrenRUT/HAHpSALacto + Bifido + Strep3000A + 360F + 60M
Shavakhi et al[41],2013180AdultsRUT/HAUBTLacto + Bifido + Strep2000A + 480B + 1000C + 40M
Kyriakos et al[42], 201370AdultsRUT + HAUBTSaccha2000A + 1000C + 40M
Jiang et al[43], 2013280AdultsRUT + GiemsaUBTBacillus2000A + 60La + 3000Le
Dajani et al[44], 20132301BothUBT/RUT/HA/HpSAUBTBifido2000A + 1000C/800Me + PPI
Deguchi et al[45], 2012229AdultsCulture/(HA + RUT)(UBT + HpSA) + CultureLacto1500A + 400C + 20R
Tolone et al[46], 201268ChildrenUBT + HAUBTLacto + Bifido + Strep6000A + 1800C + 60M
Mirzaee et al[47], 20122102AdultsUBTUBTNM2000A + 1000C + 40P
Manfredi et al[48], 20122227AdultsRUT/HpSAHpSALacto + Bifido + Strep2000A + 1000C + 40E + 1000Ti
Du et al[49], 20122234AdultsUBT/RUT/GiemsaUBTLacto + Bacillus + Strep2000A + 1000C + 40M
Bekar et al[50], 201182AdultsUBTUBTLacto + Bifido2000A + 1000C + 60La
Yoon et al[51], 2011337NMUBT/RUT/HAUBTLacto + Bifido + Strep2000A + 1000C + 80E
He et al[52], 201184AdultsUBT + RUTUBT + RUTLacto + Bifido + Entero2000A + 1000C + (40-60)R + 1000Ti
Xu et al[53], 2010120NM(UBT/RUT) + HAUBTLacto + Bifido + Entero2000A + (20-40)E + 200F
Yaşar et al[54], 201076AdultsHAUBTBifido2000A + 1000C + 80P
Wen et al[55], 2010200NMUBT + RUTUBTLacto + Bifido + Entero2000A + 40P + 800Ti
Song et al[56], 20102991AdultsRUT/HAUBTSaccha2000A + 1000C + 40M
Szajewska et al[57], 200983Children2 of (UBT, RUT, HA)UBTLacto3000A + 1200C + 60M
Hurduc et al[58], 200990ChildrenRUT + HARUT + HASaccha3000A + 1800C + 60E/60M
Francavilla et al[59], 200840NM3 of (UBT, RUT, HA, HpSA)UBT + HpSALacto2000A + 1000C + 40R + 1000Ti (sequential)
Kim et al[60], 2008347AdultsUBT/RUT/HAUBTLacto + Bifido + Strep2000A + 1000C + PPI
Huang et al[61], 2008120NMUBT + RUTUBTLacto + Bifido + Entero1000C + (20-40)E/(20-40)R + 1000Rn
Imase et al[62], 2008219NMNMNMClost1500A + 800C + 60La
Cindoruk et al[63], 2007124AdultsHA + GiemsaUBTSaccha2000A + 1000C + 60La
Park et al[64], 2007352AdultsHAUBTBacillus + Strep2000A + 1000C + 40M
de Bortoli et al[65], 2007206NMHA/(UBT + HpSA)UBTLacto + Bifido + Strep2000A + 1000C + 40E
Sahagún-Flores et al[66], 200771AdultsHAUBTLacto2000A + 1000C + 40M
Lionetti et al[67], 200640Children2 of (UBT, RUT, HA)UBTLacto3000A + 900C + 60M + 1200Ti (sequential)
Goldman et al[68], 200665ChildrenUBTUBTLacto + Bifido3000A + 900C + 60M
Sheu et al[69], 2006138NMUBT + HAUBTLacto + Bifido + Strep2000A + 360B + 40M + 1000Me
Ziemniak et al[70], 20062245AdultsUBTUBTLacto2000A + 1000C + 80P
Sýkora et al[71], 200586Children2 of (RUT, HA, culture) + HpSAUBT + HpSALacto3000A + 900C + (1200-2400)M
Myllyluoma et al[72], 200547AdultsUBT + EIAUBTLacto + Bifido + Propionibacterium2000A + 1000C + 60La
Duman et al[73], 2005389NMUBT + HANMSaccha2000A + 1000C + 40M
Shimbo et al[74], 200535NMRUT + CultureUBTClost3000A + 800C + 120La
Cao et al[75], 2005128NMUBT + RUTUBT + RUTLacto + Bifido + Entero2000A + 300B + 40M + 800Me
Nista et al[76], 2004106AdultsUBTUBTBacillus2000A + 1000C + 40R
Tursi et al[77], 200470NMRUT + HAUBTLacto3000A + 800B + 40E/40P + 1000Ti
Guo et al[78], 200497AdultsRUT + HAUBTClost1000A + 200F + 40M
Sheu et al[79], 2002160NM(RUT/HA) + UBTUBT/RUT/HALacto + Bifido2000A + 1000C + 60La
Cremonini et al[80], 2002285AdultsUBTUBTLacto1000C + 40R + 1000Ti
Armuzzi et al[81], 2001a60AdultsUBT + EIAUBTLacto1000C + 40R + 1000Ti
Armuzzi et al[82], 2001b120AdultsUBT + EIAUBTLacto1000C + 80P + 1000Ti
Canducci et al[83], 2000120NMUBT + HAUBT + HALacto1500A + 750C + 40R
Table 2 Effect of probiotics plus standard therapy vs standard therapy on adverse events
Adverse EventTrials (n)Participants (n)Probiotics group, %Control groupRR and 95%CIP valueHeterogeneity (P value)
Diarrhea2649355.71%13.72%0.41 (0.30-0.57)< 0.00158% (P < 0.001)
Nausea/vomiting2340676.95%12.83%0.60 (0.48-0.76)< 0.00123% (P = 0.16)
Epigastric discomfort818066.09%14.13%0.57 (0.44-0.74)< 0.0010% (P = 0.60)
Abdominal bloating13151610.82%14.51%0.70 (0.55-0.90)0.0050% (P = 0.53)
Abdominal pain1013738.40%13.05%0.54 (0.35-0.83)0.00531% (P = 0.16)
Constipation1320213.96%6.73%0.55 (0.37-0.81)0.0020% (P = 0.77)
Taste disturbance19361111.79%18.76%0.63 (0.48-0.83)< 0.00173% (P < 0.001)
Table 3 Subgroup analyses comparing the effect of probiotics plus standard therapy vs standard therapy on eradication rate based on intention-to-treat
SubgroupsStudies (n)Patients (n)Probiotics groupControl groupRR and 95%CIP valueP value for Q statistics
Age
Adults23411681.86%73.23%1.12 (1.09-1.16)< 0.0010.224
Children749876.89%64.78%1.19 (1.07-1.32)0.0020.535
Probiotic strains
Multiple22359883.29%73.73%1.12 (1.08-1.17)< 0.0010.046
Single21290881.60%70.60%1.16 (1.11-1.21)< 0.0010.724
Dosage of probiotics (CFU/d)
≥ 5 × 10915247082.84%73.06%1.13 (1.08-1.18)< 0.0010.571
< 5 × 10921328381.49%70.69%1.14 (1.09-1.20)< 0.0010.046
Duration of probiotic intake
≥ 15 d17341181.15%71.35%1.14 (1.10-1.18)< 0.0010.976
< 15 d24258582.30%71.28%1.12 (1.06-1.18)< 0.0010.022
Duration of standard therapy
> 7 d17205081.79%74.32%1.11 (1.06-1.17)< 0.0010.167
= 7 d27455882.39%70.97%1.16 (1.12-1.20)< 0.0010.502
Duration between therapy ending and assessment
> 4 wk20252083.86%73.36%1.16 (1.11-1.21)< 0.0010.282
= 4 wk22398480.78%70.91%1.14 (1.10-1.18)< 0.0010.358
Probiotic (containing the following strains)
Lactobacillus31416582.67%73.05%1.14 (1.10-1.18)< 0.0010.088
Bifidobacterium20305982.66%71.69%1.14 (1.10-1.19)< 0.0010.058
Streptococcus11226281.47%72.65%1.11 (1.06-1.17)< 0.0010.085
Saccharomyces4127581.14%69.94%1.15 (1.08-1.24)< 0.0010.594
Bacillus477280.71%69.74%1.17 (1.08-1.28)< 0.0010.408
Enterococcus565287.30%73.29%1.17 (1.06-1.30)0.0030.046
Clostridium315193.06%86.08%1.08 (0.97-1.21)0.1640.456
Therapy regimens
First-line16347481.02%71.00%1.13 (1.08-1.17)< 0.0010.260
Second-line343588.63%81.11%1.08 (1.00-1.17)0.0580.185
Not specified25269982.67%72.25%1.18 (1.13-1.23)< 0.0010.268