Publication:

A comparative study of probiotic, prokinetic based triple therapy with USFDA regimen in the eradication of Helicobacter pylori in a tertiary care hospital

Background Helicobacter pylori infection has been associated with peptic ulcer disease, gastric carcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma. Its eradication is important and current regimens are associated with antibiotic resistance, side effects and poor patient compliance. Probiotics supplementation can overcome the above problem and additions of prokinetics improve dyspepsia symptoms and thereby improve patient compliance. So the aim of the study was to compare efficacy and safety of standard United States Food and Drug Administration (USFDA) regimen with probiotic, prokinetic based novel regimen.

Methods 100 patients diagnosed with H. pylori infection were randomly assigned into two eradication regimen groups viz., group A and group B. Group A received standard USFDA regimen, amoxicillin 1 gm, lansoprazole 30 mg and clarithromycin 500 mg twice a day for 2 weeks and group B received a probiotic and prokinetic itopride 50 mg thrice daily, pantoprazole 40 mg, amoxicillin 1 gm and clarithromycin 500 mg twice daily for 2 weeks. Patients with Rapid Urease Test (RUT) and histopathology reports negative for H. pylori were considered as eradicated and then the percentage of eradication rate in both groups was compared.

Results H. pylori eradication rates were more in group B compared to group A (84% vs 70%, p =0.096 at 95% CI). The occurrence of side effects was less in group B compared to group A (30% vs 46%, p= 0.099). Diarrhoea was statistically less in group B compared to group A (p< 0.05).

Conclusions Probiotics supplementation increases eradication rates of anti H. pylori therapy and improves tolerability by reducing side effects especially diarrhoea. Prokinetics and probiotic based novel regimen improved dyspepsia symptoms and patient compliance.