Comparison of combination of probiotic and standard therapy compared to standard therapy on eradication of Helicobacter pylori infection in children

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Fransisca Theresia Aryani
Agus Firmansyah
Abdul Latief


Background Helicobacter pylori (H. pylori) infection is thought to be the etiology of chronic gastritis, peptic ulcer, and risk factor for gastric cancer. Management of H. pylori infection in children is associated with several problems such as compliance to therapy, untolerated side effects, and antibiotic resistance. Probiotic is reported to give beneficial effect in the management of H. pylori infection and there is no study yet on the effect of probiotic in eradication of H. pylori infection in Indonesian children.
Objectives To study the effect of additional probiotic in the standard therapy on the rate of H. pylori infection eradication in children and its side effect.
Methods This was a double blind randomized controlled trial performed in 23 children with H. pylori infection at Kampung Melayu and Rawa Bunga District. The diagnosis was determined based on Helicobacter pylori stool antigen test (HpSA). Subjects were randomly assigned to either receive receive amoxiycilin, clarithromycin, omeprazole, and probiotic (2 x 109 cfu of Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12) or amoxicillin, clarithromycin, omeprazole dan placebo (maltodextrin). HpSA examination was evaluated again after 2 weeks of therapy.
Results Two of 13 subjects in the treatment group and 6 of 10 subjects in the control group experienced side effects. Eradication rate in the treatment group is higher than the control group (13/13 vs 7/10) but the correlation between additional probiotic with the eradication rate of H. pylori is not statistically significant.
Conclusions Probiotic can reduce the incidence of side effects due to antibiotic used in H. pylori eradication (2/13 vs 6/10, p < 0.012). [Paediatr Indones. 2010;50:38-41].

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How to Cite
Aryani F, Firmansyah A, Latief A. Comparison of combination of probiotic and standard therapy compared to standard therapy on eradication of Helicobacter pylori infection in children. PI [Internet]. 3Mar.2010 [cited 14Aug.2020];50(1):38-1. Available from:
Pediatric Gastrohepatology
Received 2016-08-15
Published 2010-03-03


Hegar B. Infeksi Helicobacter pylori pada anak. Sari Pediatri. 2000;2:82-9.
2. Goodwin CS, Mendall MM, Northfield TC. Helicobacter pylori infection. The Lancet. 1997;349:265-9.
3. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. 2002;347:1175-86.
4. Kato S, Fujimura S, Udagawa H, et al. Antibiotic resistance of Helicobacter pylori strains in jJapanese children. J Clin Microbiol. 2002;40:649-53.
5. R Raymond J, Kallach N, Bergeret M, Benhamou PH, Barbet JP, General D, Dupont C. Effect of metronidazole resistance on bacterial eradication of Helicobacter pylori in infected children. Antimicrob Agents Chemotherapy. 1998;42:1334-5.
6. Cayla R, Zerbib F, Talbi P, Mergraud F, Lamouliatte H. Pre- and post- treatment clarithromycin resistance of Helicobacter pylori strains: key factor of treatment failure [Abstract]. Gut. 1996;37(Suppl.):A55.
7. Cremonini F, Caro SD, Covino M, et al. Effect of different probiotics preparations on Anti-Helicobacter pylori therapy-related side effect: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97:2744-48.
8. Felley C, Michetti P. Probiotics and Helicobacter pylori. Best Practice & Research Gastroenterol. 2003;17:785-91.
9. Canducci F, Armuzzi A, Cremonini F, Cammarota G, Bartolozzi F, Pola P et al. A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther. 2000;14:1625-29.
10. Pinchuk IV, Bressollier P, Verneuil B, et al. In vitro Anti-Helicobacter pylori activity of the probiotic strain Bacillus subtilis 3 is due to secretion of antibiotics. Antimicrob Agents Chemotherapy. 2001;45:3156-61.
11. M Myllyluoma E, Veijola L, Ahlroos T, Tynkkynen S, Kankuri S, Vapaatalo H, et al. Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy-a placebo-controlled, double-blind randomized pilot study. Aliment Pharmacol Ther. 2005;21:1263-72.
12. Oderda G, Rapa A, Marinello D, Ronchi B, Zavallone A. Usefulness of Helicobacter pylori stool antigen test to monitor response to eradication treatment in children. Aliment Pharmacol Ther. 2001;15: 203-6.
13. Ito M, Tanaka S, Kim S, Tahara K, Kawamura Y, Sumii M, et al. A combination of the Helicobacter pylori stool antigen test and urea breath test is useful for clinical evaluation of eradication therapy: A multicenter study. J Gastroenterol and Hepato. 2005;20: 1241-45.
14. B Braden B, Posselt HG, Ahrens P, Kitz R, Dietrich CF, Caspary WF. New immunoassay in stool provides an accurate noninvasive diagnostic method for Helicobacter pylori screening in children. Pediatrics. 2000;106: 115-7.
15. Sheu BS, Wu JJ, Lo CY, Wu HW, Chen JH, Lin YS, et al. Impact of supplement with Lactobacillus- and Bifidobacterium-containing yoghurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2002; 16: 1669-75.
16. Henry KCJ, Mitchell DJ, Avitzur Y, dkk. Probiotics reduce bacterial colonization and gastric inflammation in H. pylori-Infected mice. Digestive Diseases and Sciences. 2004;49:1095-1102.
17. Sakamoto I, Igarashi M, Kimura K, Takagi A, Miwa T, Koga Y. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother. 2001;47:709-10.
18. Shimizu T, Haruna H, Hisada K, Yamashiro Y. Effects of Lactobacillus gasseri OLL2716(LG21) on Helicobacter pylori infection in children. J Antimicrob Chemother. 2002;50:617-18.
Paediatr Indones, Vol. 50, No. 1, January 2010 • 41
Fransisca Theresia Aryani et al: Combination of probiotic and standard therapy on eradication of H. pylori infection in children
19. U Ushiyama A, Tanaka K, Aiba Y. Lactobacillus gasseri OLL2716 as a probiotic in clarithromycin-resistant Helicobacter pylori infection. J Gastroenterol Hepatol. 2003;18:986-91.
20. Bielanski W, Ziemniak W, Plonka M, Dobrzanska M, Kaminska A, Konturek SJ, et al. Improvement of anti-Helicobacter pylori therapy by the use of commercially available probiotics. Gut. 51, suppl 11, A98, 2002.
21. Wang KY, Li SN, Liu CS, Perng DS, Su YC, Wu DC, et al. Effects of ingesting Lactobacillus- and Bifidobacterium-containing yogurt in subjects with colonized Helicobacter pylori. Am J Clin Nutr. 2004;80:737-41.
22. Cruchet S, Obregon MC, Salazar G, Diaz E, Gotteland M. Effect of the ingestion of a dietary product containing Lactobacillus johnsonii La1 on Helicobacter pylori colonization in children. Nutrition. 2003;19:716-21.
23. Coconier MH, Lievin V, Hemery E, dkk. Antagonistic activity against Helicobacter pylori infection in vitro and in vivo by the human Lactobacillus acidophilus strain LBLB. Appl Env Microbiol. 1998;64:4573-80.
24. Armuzzi A, Cremonini F, Bartolozzi F, Canducci F, Candelli M, Ojetti V et al. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2001;15:163-9.
25. Tursi A, Brandimarte G, Giorgetti GM, Modeo ME. Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Med Sci Monit. 2005;10:CR662-6.
26. Kato S, Takeyama J, Ebina K, Naganuma H. Omeprazole-based dual and triple regimens for Helicobacter pylori eradication in children. Pediatrics. 1997; 100:e3.