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Table 4 Recent meta-analysis studies on the effect of probiotics in the treatment of H. pylori infection

From: Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections

First author Year Sample size Eradication regimen Probiotics Conclusion remarks Significance Ref
Tong et al 2007 1671 First-line and second-line therapy (triple and bismuth containing quadruple therapy) B. clausii, Lactobacillus, Saccharomyces ER: RR: 1.84; 95% CI: 1.34–2.54
AE: 0.44; 95% CI: 0.3–0.6
Both significant
AE was adverse event
ER was eradication rate
[169]
Sachdeva et al 2009 963 First-line therapy (Triple and Quadruple) Lactobacillus, Bifidobacterium ER: 1.91; 95% CI: 1.3–2.6
AE: 0.51; 95% CI: 0.1–2.5 but AE was not significant
Reduction of adverse event rate was not significant [170]
Zou et al 2009 1372 First-line therapy
(Triple)
Lactobacillus ER: 1.78; 95% CI: 1.21–2.62
AE: OR was 0.49 (95% CI = 0.24–1.02)
Both significant [171]
Szajewska et al 2010 1307 First-line therapy
(Triple)
S. boulardii ER: 1.13, 95% CI 1.05–1.21
AE: RR 0.46, 95% CI 0.3–0.7
Both significant [172]
Zheng et al 2013 1163 First-line therapy
(Triple)
Lactobacillus RR: 1.14; 95% CI: 1.06–1.22 (significant increase of eradication rate) but no significant reduction of overall adverse event Reduction of adverse event rate was not significant [173]
Wang et al 2013 1469 First-line and second-line therapy (triple and bismuth containing quadruple therapy) Bifidobacterium, Lactobacillus ER: 2.066 (95% CI, 1.398–3.055
AE: 0.305; 95% CI, 0.117–0.793)
Both significant [174]
Zhu et al 2014 2259 standard triple H. pylori Lactobacillus, Bifidobacterium, Saccharomyces ER: 1.67 (95%CI: 1.38–2.02)
AE: (OR = 0.49, 95%CI: 0.26–0.94
Both significant [175]
Dang et al 2014 4459 First-line therapy
(Triple)
L. acidophilus, L. casei DN-114001, L. gasseri, Bifidobacterium infantis 2036 Curing rate was significantly increase in probiotics (RR: 1.11; 95%CI: 1–1.1) as well as reduce of adverse event (RR: 0.73; 95%CI: 0.5–0.9) Both significant [176]
Zhang et al 2015 6997 First-line and second-line therapy (triple And bismuth containing quadruple therapy) Lactobacillus, Bifidobacterium, Streptococcus, Saccharomyces, Enterococcus, Bacillus ER: RR = 1.13; 95%CI: 1.10–1.16
AE: RR = 0.59; 95%CI: 0.48–0.71
Both significant [177]
Lu et al 2016 3349 First-line therapy
(triple)
Lactobacilli, Bifidobacteria, Bacillus clausii, E. faecium ER: OR 1.44, 95% CI: 0.87, 2.39 but not significant
AE: probiotics did improve the adverse effects
OR 0.56, 95% CI: 0.31, 1.01
Both not significant [178]
Lu et al 2016 2306 First-line therapy
(Triple)
Lactobacillus, Bifidobacterium Eradication rate in probiotic supplementation group was significantly higher than control (RR: 1.15; 95%CI: 1.1–1.2) and reducing adverse event (RR: 0.71; 0.5–0.9) probiotic supplementation increased eradication of triple therapy in both 7 and 14-days Both significant [179]
Si et al 2017 2466 First-line therapy
(bismuth containing quadruple therapy)
Lactobacillus Eradication rate was significant increase in probiotics (89% vs. 84.7% for first-line)
(91% vs. 73.8% for second-line)
significant [180]
Losurdo et al 2018 NA NA Lactobacillus ER: UBT value: 8.61% vs. 0.19%
AE: 1, 95%CI: 0.06–18.08 not siginificANT FOR AE
Reduction of adverse event rate was not significant [181]
Shi et al 2019 8924 First-line therapy (Triple and Quadruple) Lactobacillus RR: 1.14; 95%CI: 1.10–1.18
(significant increase of eradication rate) and reduced side effects
Both significant [182]
Yu et al 2019 724 First-line therapy
(Triple
Lactobacillus Eradication rate was significantly increase in Lactobacillus supplement group (RR: 1.1; 95%CI: 1–1.2) and derease significantly adverse event (RR: 0.36; 95%CI: 0.1–0.7) Both significant [183]
Pourmasoumi et al 2019 525 First-line therapy (Triple and Quadruple) Lactobacillus, Bifidobacterium Saccharomyces Eradication: RR: 1.28; 95% CI: 1.15–1.43
Adverse: RR: 0.90; 95% CI: 0.69–1.16
Both significant [184]
Zhou et al 2019 3592 First-line therapy (Triple) S. boulardii ER: 1.09, 95% CI:1.05‐1.13
AE: RR = 0.33, 95%CI:0.16‐0.69
Both significant [185]