Abstract:
Introduction: Both the effectiveness and tolerability of Helicobacter py-
lori (H.p.) eradication therapy regimens are important in the management
of H.p. infection, since the presence of side effects significantly reduces
compliance between the doctor and the patient and sometimes can lead
to treatment interruption. Our study aimed to compare the efficacy and
tolerability of eradication therapy depending on the addition of Saccharo-
myces boulardii or a synbiotic complex.
Aims & Methods: The study included 78 patients (54 women and 24 men)
with confirmed H.p. infection using validated tests, without previous
eradication in the anamnesis. All patients underwent a course of eradica-
tion therapy, which included proton pump inhibitor (PPI) + amoxicillin (A)
+ clarithromycin (C) + bismuth subcitrate (B). Patients were divided into
2 groups: in group A (37 patients, 25 women, 12 men, mean age 44±3.2
years) S. boulardii CNCM I-745 was added to the mentioned regimen.
In group B (41 patients, 29 women, 12 men, mean age 47±2.8 years), a
synbiotic complex containing strains of probiotic bacteria Lactobacillus
acidophilus, Lactobacillus plantarum, Lactobacillus delbrueckii subsp.
bulgaricus, Lactobacillus fermentum, Lactobacillus rhamnosus, Lacto-
bacillus casei subsp. casei, Streptococcus thermophilus, Bifidobacterium
bifidum, Bifidobacterium longum, Bifidobacterium adolescentis, Propi-
onibacterium freudenreichii subsp. Shermanii, prebiotics inulin and lac-
tulose were added to the indicated regimen. The duration of eradication
therapy was 10 days. The duration of taking the probiotic and synbiotic
complex ‒ 15 days.
Results: In group A, the effectiveness of the PPI+A+C+B regimen with the
addition of S. boulardii was 75.7%. In group B (with the addition of a syn-
biotic) - 87.8%. We compared the tolerability of the indicated regimens. In
no case (in both groups) was the treatment interrupted due to the pres-
ence of serious side effects. In total, 20 (54.1%) patients from group A and
17 patients (41.5%) from group B reported non-serious adverse events,
including nausea (group A ‒ 8 patients (21.6%), group B ‒ 6 (14.6%), bitter
taste in the mouth (group A ‒ 16 patients (43.2%), group B ‒ 15 (36.6%),
and diarrhoea (group A ‒ 6 patients (16.2%), group B ‒ 0 (0%). No other
adverse events were documented. Comparing gastrointestinal symptoms
using the Gastrointestinal Symptom Rating Scale (GSRS) showed that in
group A, mean values of the total score before treatment were 35.9±3.14
points, vs 26.2±1.64 points 20 days after the eradication course (p<0.05).
In group B 34.1±2.44 points before treatment, vs 21.7±1.98 points 20 days
after the eradication course (p<0.05). Comparing the total score of the
GSRS questionnaire after treatment between groups A and B also showed
a significant difference: 26.2±1.64 points in group A vs 21.7±1.98 points in
group B (p<0.05).
Conclusion: Our study revealed better efficacy (87.8%) of the eradication
regimen PPI+A+C+B with the addition of a synbiotic compared to the sim-
ilar regimen with the addition of Saccharomyces boulardii (75.7%) in pa-
tients from Vinnytsia region, Ukraine. In addition, it was found that when
the synbiotic complex was added, side effects of eradication therapy were
noted in a smaller percentage of patients and significantly (p<0.05) lower
values of the total score of the GSRS questionnaire were noted 20 days
after treatment, in contrast to the regimen with the addition of Saccharo-
myces boulardii.
Disclosure: Nothing to disclose.
