Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis

Table 1 Main characteristics of the studies included in the quantitative analysis

Ref.	Nation	Age and sex	Probiotic strain and dose	Diagnosis	Control of eradication	Eradication rate % (n/N)
Boonyaritichaikij et al[27], 2009	Japan	62 ± 14 yr	Cheese with L. gasseri OLL2716 5 × 108 CFU/g for 12 mo	SAT	SAT after 12 mo	Probiotic: 29.3% (24/82)
		Male sex: 54.5%				Placebo: 0% (0/6)
Dore et al[28], 2014	Italy	Mean age: 51 yr (range, 21-68)	L. reuteri 108 CFU/tablet bid + Pantoprazole 20 mg bid for 60 d	UBT	UBT after 30-40 d	14.3% (3/21)
		Male sex: 13.6%
Francavilla et al[29], 2008	Italy	53.3 ± 13.3 yr (probiotics)	L. reuteri ATCC55730 108 CFU/tablet bid for 28 d	UBT (cut-off 3.5%), SAT, RUT, histology	UBT after 4 wk	Probiotic: 0% (0/20)
		52.4 ± 13.1 yr (placebo)				Placebo: 0% (0/20)
		Male sex: 57.5%
Gotteland et al[30], 2005	Chile	8.5 ± 1.7	L. acidophilus LB 109/tablet bid or S. boulardii 250 mg + inulin 5 g bid for 8 wk	UBT (cut-off 5‰)	UBT after 1 d	9.3% (9/97)
		Male sex: 49.6%				L. acidophilus 6.5% (3/46)
						S. boulardii 11.8% (6/51)
Myllyluoma et al[31], 2007	Finland	Mean age: 51 yr (range, 40-69)	Multi-strain (L. rhamnosus GG, L. rhamnosus LC705, P. freudenreichii JS, B. lactis Bb12) 2.5 × 109 CFU/day for 8 wk	UBT (cut-off 2.2%), RUT, histology	UBT after 8 wk	0% (0/6)
Pantoflickova et al[32], 2003	Switzerland	25 ± 5 yr	L. johnsonii bid for 3 wk, then once daily for 13 wk	UBT (cutoff 5%), histology, culture, RUT, serology	UBT, culture at the end of treatment	Probiotic: 0% (0/25)
		Male sex: 50%				Placebo: 0% (0/25)
Rosania et al[33], 2012	Italy	52.4 ± 21.7 yr (probiotics)	Multi-strain (S. termophilus, L. acidophilus, B. longum, L. plantarum, B. brevis, L. paracasei, B. infantis, L. delbrueckii) 1800 × 109/d for 10 d	UBT (cut-off 4%)	UBT after 4 wk	Probiotic: 32.5% (13/40)
		48.7 ± 25.3 yr (placebo)				Placebo: 0% (0/40)
		Male sex: 42.5%
Sakamoto et al[34], 2001	Japan	50.1 ± 7.4 yr	Yoghurt + L. gasseri OLL2716 1-1.4 × 107 CFU/g bid for 8 wk	UBT (cut-off 5%)	UBT after 9 wk	0% (0/29)
		Male sex: 93.1%
Shimizu et al[35], 2002	Japan	Mean age: 12.1 yr (range, 7.4-15.8) Male sex: 41.7%	Yoghurt + L. gasseri OLL2716 1-1.4 × 107 CFU/g bid for 8 wk	SAT, UBT	SAT, UBT after 4 and 10 wk	0% (0/12)
Wang et al[36], 2004	China	Not available	Multi-strain yoghurt (L. acidophilus La5, B. lactis Bb12, L. bulgaricus, S. termophilus) > 107 bacteria/mL for 6 wk	UBT (cut-off 3.5%), histology	UBT after 8 wk	Probiotic: 1.7% (1/59)
						Placebo: 0% (0/11)
Namkin et al[37], 2016	Iran	Age range of 9-12 yr	S. boulardii 250 mg/d for 1 mo	SAT	SAT after 8 wk	Probiotic: 0% (0/12)
		Male sex: 20.8%				Placebo: 0% (0/12)

CFU: Colony forming units; RUT: Rapid urease test; SAT: Stool antigen test; UBT: Urea breath test.

Table 2 Quality assessment according to the type of studies

Ref.	Type of study	Jadad score1	QATCSS score2
Boonyaritichaikij et al[27], 2009	Randomized, single blind placebo-controlled, pilot	3	NA
Dore et al[28], 2014	Prospective, single center, open label pilot study	NA	8
Francavilla et al[29], 2008	Randomized, double blind placebo-controlled	4	NA
Gotteland et al[30], 2005	Randomized, open study	3	NA
Myllyluoma et al[31], 2007	Prospective, single center, open label pilot study	NA	7
Pantoflickova et al[32], 2003	Randomized, double blind placebo-controlled	4	NA
Rosania et al[33], 2012	Randomized, double blind placebo-controlled	4	NA
Sakamoto et al[34], 2001	Single center, open label pilot study	NA	6
Shimizu et al[35], 2002	Single center, open label pilot study	NA	6
Wang et al[36], 2004	Randomized, double blind placebo-controlled	2	NA
Namkin et al[37], 2016	Randomized, double blind placebo-controlled	5	NA

¹Jadad scale reaches a maximum score of 5;

²QATCSS reaches a maximum score of 9. NA: Not applicable.