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Lactobacillus-supplemented therapy increases Helicobacter pylori eradication success by 10% and reduces adverse eventsAdding Lactobacillus to antibiotics improves success in treating stomach infections

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Key Takeaway
Consider Lactobacillus-supplemented triple therapy to improve eradication success and reduce adverse events in adults.

This meta-analysis of randomized controlled trials evaluated the efficacy and safety of Lactobacillus-supplemented eradication therapy compared to standard therapy for Helicobacter pylori infection in a population of 4010 patients. The primary outcome of eradication success showed a statistically significant increase with the addition of Lactobacillus (RR 1.10; 95%CI 1.05-1.14). The number needed to treat for success was 13.

Regarding safety, the meta-analysis reported a 30% relative reduction in the risk of adverse events for the Lactobacillus-supplemented group (RR 0.70; 95%CI 0.58-0.84). However, the authors noted specific limitations regarding the scope of these results. The improved eradication success was observed only in patients receiving triple therapy regimens, and the reduction in adverse event risk was observed only among adults.

Clinical application of these findings should be tempered by the specific limitations regarding regimen type and patient age. While the meta-analysis suggests a benefit in both efficacy and tolerability, the evidence for improved eradication is specifically linked to triple therapy, and the safety benefit is specific to the adult population.

How this fits prior evidence

This meta-analysis addresses a gap in evidence regarding adjunctive therapies for Helicobacter pylori infection. While previous coverage has focused on non-invasive biomarkers for pediatric infection and the reduction of antibiotics in children with fever, this study provides specific data on the role of Lactobacillus in improving eradication success and reducing adverse events in adult patients using triple therapy.

Living with a stomach infection caused by the bacteria Helicobacter pylori can be a frustrating experience. To clear the infection, patients usually take a course of antibiotics. However, these medications can sometimes cause uncomfortable side effects, making the treatment process difficult for many people.

A large review of clinical trials involving over 4,000 patients looked at what happens when a probiotic called Lactobacillus is added to the standard antibiotic plan. The results showed that patients who took the probiotic along with their antibiotics had a higher success rate in clearing the infection. This improvement was specifically noted in patients who were already using a triple therapy regimen.

Safety was also a key part of the study. For adults, adding the probiotic was linked to a 30% lower risk of experiencing side effects from the treatment. While the results are promising for managing these infections more comfortably, the specific benefits were only confirmed for adults using triple therapy. You should talk to your doctor to see if this combination is right for your specific health needs.

What this means for you:
Adding Lactobacillus to triple therapy can improve success rates and reduce side effects for adults with stomach infections.

Common questions

Does adding Lactobacillus help clear the infection?

Yes, the study found that adding Lactobacillus to the standard treatment led to a 10% relative increase in success rates for clearing the Helicobacter pylori infection. This improvement was specifically observed in patients who were already using a triple therapy regimen.

Are there fewer side effects with this treatment?

Patients who took the Lactobacillus supplement with their antibiotics had a 30% lower risk of experiencing side effects. This reduction in adverse events was specifically noted among adult patients during the treatment process.

Who specifically benefits from adding the probiotic?

The data shows that the improved success rates and the reduction in side effects were specifically observed in adult patients who were using a triple therapy regimen to treat their infection.

Study Details

Study typeMeta analysis
Sample sizen = 4,010
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
PURPOSE: Helicobacter pylori eradication therapies supplemented with Lactobacillus spp. may improve eradication rates and reduce adverse events by modulating gut microbiota and immune responses. This meta-analysis aimed to evaluate the efficacy and safety of Lactobacillus-supplemented Helicobacter pylori eradication therapy. METHODS: We systematically searched for randomized controlled trials (RCTs) comparing standard Helicobacter pylori eradication therapy with and without Lactobacillus in PubMed, Embase, and Cochrane Library up to August 2026. The primary outcome was eradication success, and the secondary outcome was adverse events. We calculated pooled risk ratios (RR) with 95% confidence intervals (CIs) using a random-effects model. We also estimated the number needed to treat (NNT) for eradication success and conducted subgroup analyses by antibiotic therapy type, duration of antibiotic treatment, Lactobacillus strain type, Lactobacillus dosage, period of Lactobacillus use, probiotic formulation, geographical region, and age range. This review was registered in PROSPERO (CRD42024611138). RESULTS: Thirty-two RCTs (4,010 patients) were included. Lactobacillus-supplemented eradication therapy improved eradication success (RR 1.10; 95%CI 1.05-1.14; NNT 13) and reduced the risk of adverse events (RR 0.70; 95%CI 0.58-0.84). Subgroup analyses showed significant differences in eradication success by antibiotic regimen and in adverse event risk by age group. Improved eradication success with Lactobacillus-supplemented eradication therapy was observed only with triple therapy regimens, whereas adverse event risk was reduced only among adults. CONCLUSION: Lactobacillus-supplemented eradication therapy was associated with a 10% relative increase in Helicobacter pylori eradication success and a 30% relative reduction in treatment-related adverse events compared with the control group.
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