Association of a probiotic to a Helicobacter pylori eradication regimen does not increase efficacy or decreases the adverse effects of the treatment: a prospective, randomized, double-blind, placebo-controlled study
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Citações na Scopus
56
Tipo de produção
article
Data de publicação
2013
Título da Revista
ISSN da Revista
Título do Volume
Editora
BIOMED CENTRAL LTD
Autores
OLIVEIRA, Marice Nogueira de
BOGSAN, Cristina S.
Citação
BMC GASTROENTEROLOGY, v.13, article ID 56, 8p, 2013
Resumo
Background: The treatment for the eradication of Helicobacter pylori (H. pylori) is complex; full effectiveness is rarely achieved and it has many adverse effects. In developing countries, increased resistance to antibiotics and its cost make eradication more difficult. Probiotics can reduce adverse effects and improve the infection treatment efficacy. If the first-line therapy fails a second-line treatment using tetracycline, furazolidone and proton-pump inhibitors has been effective and low cost in Brazil; however it implies in a lot of adverse effects. The aim of this study was to minimize the adverse effects and increase the eradication rate applying the association of a probiotic compound to second-line therapy regimen. Methods: Patients with peptic ulcer or functional dyspepsia infected by H. pylori were randomized to treatment with the furazolidone, tetracycline and lansoprazole regimen, twice a day for 7 days. In a double-blind study, patients received placebo or a probiotic compound (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum and Streptococcus faecium) in capsules, twice a day for 30 days. A symptom questionnaire was administered in day zero, after completion of antibiotic therapy, after the probiotic use and eight weeks after the end of the treatment. Upper digestive endoscopy, histological assessment, rapid urease test and breath test were performed before and eight weeks after eradication treatment. Results: One hundred and seven patients were enrolled: 21 men with active probiotic and 19 with placebo plus 34 women with active probiotic and 33 with placebo comprising a total of 55 patients with active probiotic and 52 with placebo. Fifty-one patients had peptic ulcer and 56 were diagnosed as functional dyspepsia. The per-protocol eradication rate with active probiotic was 89.8% and with placebo, 85.1% (p = 0.49); per intention to treat, 81.8% and 79.6%, respectively (p = 0.53). The rate of adverse effects at 7 days with the active probiotic was 59.3% and 71.2% with placebo (p = 0.20). At 30 days, it was 44.9% and 60.4%, respectively (p = 0.08). Conclusions: The use of this probiotic compound compared to placebo in the proposed regimen in Brazilian patients with peptic ulcer or functional dyspepsia showed no significant difference in efficacy or adverse effects.
Palavras-chave
Helicobacter pylori eradication, Probiotic, Tetracycline, Furazolidone, Peptic ulcer, Functional dyspepsia, Treatment efficacy, Adverse effects
Referências
- Armuzzi A, 2001, ALIMENT PHARM THERAP, V15, P163, DOI 10.1046/j.1365-2036.2001.00923.x
- Canducci F, 2000, ALIMENT PHARM THERAP, V14, P1625, DOI 10.1046/j.1365-2036.2000.00885.x
- Cats A, 2003, ALIMENT PHARM THERAP, V17, P429, DOI 10.1046/j.0269-2813.2003.01452.x
- Chey WD, 2007, AM J GASTROENTEROL, V102, P1808, DOI 10.1111/j.1572-0241.2007.01393.x
- Coelho Luiz Gonzaga Vaz, 2005, Arquivos de Gastroenterologia, V42, P128, DOI 10.1590/S0004-28032005000200012
- Cremonini F, 2002, AM J GASTROENTEROL, V97, P2744, DOI 10.1016/S0002-9270(02)05480-1
- Cunha RPA, 2003, T ROY SOC TROP MED H, V97, P382
- CUTLER AF, 1993, AM J GASTROENTEROL, V88, P505
- Danese S, 2001, HEPATO-GASTROENTEROL, V48, P465
- Dattoli VCC, 2010, HELICOBACTER, V15, P273, DOI 10.1111/j.1523-5378.2010.00766.x
- De Francesco V, 2010, J GASTROINTEST LIVER, V19, P409
- Du YQ, 2012, WORLD J GASTROENTERO, V18, P6302, DOI 10.3748/wjg.v18.i43.6302
- Escobar-Pardo ML, 2011, J PEDIAT-BRAZIL, V87, P393, DOI [10.2223/JPED.2118, 10.1590/S0021-75572011000500005]
- Felga G, 2010, J INFECT DEV COUNTR, V4, P712, DOI 10.3855/jidc.911
- Gasparetto M, 2012, ISRN GASTROENTEROL, V2012
- GLUPCZYNSKI Y, 1990, AM J GASTROENTEROL, V85, P1545
- Godoy APO, 2003, BMC GASTROENTEROL, V3, DOI 10.1186/1471-230X-3-20
- Goh KL, 2011, HELICOBACTER, V16, P241, DOI 10.1111/j.1523-5378.2011.00841.x
- Hsieh PS, 2012, HELICOBACTER, V17, P466, DOI 10.1111/j.1523-5378.2012.00992.x
- Kindermann A, 2009, HELICOBACTER, V14, P52, DOI 10.1111/j.1523-5378.2009.00700.x
- Magalhaes PP, 2002, ANTIMICROB AGENTS CH, V46, P2021, DOI 10.1128/AAC.46.6.2021-2023.2002
- Malfertheiner P, 2012, GUT, V61, P646, DOI 10.1136/gutjnl-2012-302084
- Manfredi M, 2012, HELICOBACTER, V17, P254, DOI 10.1111/j.1523-5378.2012.00944.x
- Medeiros JAD, 2011, EUR J CLIN MICROBIOL, V30, P555, DOI 10.1007/s10096-010-1119-4
- Mendonca S, 2000, HELICOBACTER, V5, P79, DOI 10.1046/j.1523-5378.2000.00011.x
- Miranda ACP, 2010, SAO PAULO MED J, V128, P187, DOI 10.1590/S1516-31802010000400002
- Ojetti V, 2012, GASTROENT RES PRACT, DOI 10.1155/2012/740381
- Oleastro M, 2011, J ANTIMICROB CHEMOTH, V66, P2308, DOI 10.1093/jac/dkr293
- Peitz U, 2002, ALIMENT PHARM THERAP, V16, P315, DOI 10.1046/j.1365-2036.2002.01173.x
- Perez-Cobas AE, 2012, GUT
- PERITI P, 1993, DRUG SAFETY, V9, P346
- Porras C, 2012, CANC CAUSES CONTROL
- Qua CS, 2010, J DIGEST DIS, V11, P244, DOI 10.1111/j.1751-2980.2010.00445.x
- Rodrigues Maria N, 2005, Braz J Infect Dis, V9, P405, DOI 10.1590/S1413-86702005000500008
- Rodrigues MN, 2005, REV SAUDE PUBL, V39, P847, DOI 10.1590/S0034-89102005000500022
- Salvo F, 2007, J ANTIMICROB CHEMOTH, V60, P121, DOI 10.1093/jac/dkm111
- Scaccianoce G, 2008, EUR REV MED PHARMACO, V12, P251
- Selgrad M, 2011, CURR OPIN GASTROEN, V27, P565, DOI 10.1097/MOG.0b013e32834bb818
- Silva Fernando Marcuz, 2002, Rev Hosp Clin Fac Med Sao Paulo, V57, P205
- Szajewska H, 2010, ALIMENT PHARM THER, V32, P1069, DOI 10.1111/j.1365-2036.2010.04457.x
- Talley NJ, 2008, AM J GASTROENTEROL, V103, P510, DOI 10.1111/j.1572-0241.2008.01819.x
- Tolone S, 2012, ITAL J PEDIATR, V38, DOI 10.1186/1824-7288-38-63
- Vitor JMB, 2011, FEMS IMMUNOL MED MIC, V63, P153, DOI 10.1111/j.1574-695X.2011.00865.x
- Wang ZH, 2013, J CLIN GASTROENTEROL, V47, P25, DOI 10.1097/MCG.0b013e318266f6cf
- Wilhelm SM, 2011, ANN PHARMACOTHER, V45, P960, DOI 10.1345/aph.1Q104
- Yang YJ, 2012, HELICOBACTER, V17, P297, DOI 10.1111/j.1523-5378.2012.00941.x
- Yasar B, 2011, TURK J GASTROENTEROL, V21, P212
- Yoon H, 2011, J GASTROEN HEPATOL, V26, P44, DOI 10.1111/j.1440-1746.2010.06477.x
- Zaterka S, 2007, HELICOBACTER, V12, P82, DOI 10.1111/j.1523-5378.2007.00474.x
- Zhou C, 2008, WORLD J GASTROENTERO, V14, P5090, DOI 10.3748/wjg.14.5090
- Zou J, 2009, HELICOBACTER, V14, P97, DOI 10.1111/j.1523-5378.2009.00716.x