To determine the efficacy of triple therapy supplemented with a specially designed fermented milk product containing specific probiotic Lactobacillus casei (L. casei) DN-114 001 strain on Helicobacter pylori eradication in children.
Lactobacillus species possess in vitro activity against H. pylori. There are no consistent data on the impact of eradication therapy supplemented with probiotics on H. pylori cure rates in childhood in vivo.
Multicenter, prospective, randomized, double-blind controlled study. Eighty-six symptomatic H. pylori-positive children were randomized either to receive the control treatment of omeprazole, amoxicillin, and clarithromycin (OAC) for 7 days or the test treatment of omeprazole, amoxicillin, and clarithromycin for 7 days supplemented with fermented milk (Actimel) containing L. casei DN-114 001 (OAC-LC), for 14 days. H. pylori status was assessed at 4 weeks following therapy using two noninvasive tests.
Intention-to-treat (ITT) based eradication rates for the OAC-LC group were 84.6% (95% CI, 71.2%-95.5%), and 91.6% (95% CI, 76.9%-98.2%) by per-protocol (PP) analysis. Eradication in the OAC group was 57.5% (95% CI, 42.2%-72.3%) in the ITT set and 61.3% (95% CI, 44.4%-75.0%) in the PP group. Eradication success was higher in the OAC-LC group compared with the OAC group in both ITT (P=0.0045) and PP analysis (P=0.0019). Primary resistance for clarithromycin could be determined in 21.2%. Side effects were infrequent. Drug compliance was good throughout the study.
Supplementation with fermented milk, containing live special probiotic L. casei DN-114 001, confers an enhanced therapeutic benefit on H. pylori eradication in children with gastritis on triple therapy.
"The probiotic-marketed drinkable yogurt Actimel is produced by Danone and contains L. casei strain DN-114001, branded as L. casei defensis. Lactobacillus casei strain DN-114001 has been studied for its potential probiotic properties in various animal and human studies (Marcos et al., 2004; Sykora et al., 2005; Pawlowska et al., 2007; Guillemard et al., 2010). We previously isolated and characterized the L. casei strain LcA present in the Actimel product (Douillard et al., 2013). "
"The use of supplementation with fermented milk, containing probiotic L. casei DN-114 001 (Actimel) for 14 days, benefited the H. pylori eradication in children treated with omeprazole, amoxicillin, and clarithromycin during 7 days . This result suggests that the probiotic could be used as adjuvant treatment for eradication of HP in children. "
[Show abstract][Hide abstract] ABSTRACT: The bacterial colonization is defined immediately after birth, through direct contact with maternal microbiota and may be influenced during lactation. There is emerging evidence indicating that quantitative and qualitative changes on gut microbiota contribute to alterations in the mucosal activation of immune system leading to intra- or extra-intestinal diseases. A balance between pathogenic and beneficial microbiota throughout childhood and adolescence is important to gastrointestinal health, including protection against pathogens, inhibition of pathogens, nutrient processing (synthesis of vitamin K), stimulation of angiogenesis, and regulation of host fat storage. Probiotics can promote an intentional modulation of intestinal microbiota favoring the health of the host. This paper is a review about modulation of intestinal microbiota on prevention and adjuvant treatment of pediatric gastrointestinal diseases.
Gastroenterology Research and Practice 10/2012; 2012(2):676585. DOI:10.1155/2012/676585 · 1.75 Impact Factor
"A number of studies have evaluated the efficacy of probiotics as add-on treatments in the
eradication of Helicobacter pylori [39, 40]. While the results of some studies
are negative, the majority of the data show a reduced incidence of the adverse effects of
the eradication therapy. "
[Show abstract][Hide abstract] ABSTRACT: Western medicine has only recently discovered that the intestinal microbiota is a major determinant of the well-being of the host. Although it would be oversimplifying to limit the benefits of breastfeeding compared to cow milk based infant formula to differences in gastrointestinal flora, the impact of the latter has been demonstrated beyond doubt. As a consequence, gastro intestinal flora manipulation with pre- and probiotics added to infant formula or food (mainly milk based products) and/or with food supplements have become a priority area of high quality research. The composition of intestinal microbiota can be manipulated with "biotics": antibiotics, prebiotics and probiotics. Commercialised pre- and probiotic products differ in composition and dose. Major threats to the concept of developing a major role for intestinal microbiota manipulation on health are the commercialisation of products claiming health benefits that have not been validated. Legislation of food supplements and medication differs substantially and allows commercialisation of poor quality food supplements, what will result in negative experiences. Medicinal products can only be advertised for which there is scientific proof of benefit that has been demonstrated with "the same product with the same dose in the same indication". Specificity of prebiotics and probiotics strains and product specificity are of importance, although high quality evidence for this assertion is missing. Dose-efficacy studies are urgently needed. Probiotics are "generally regarded as safe", but side effects such as septicemia and fungemia have sometimes been reported in high-risk situations.
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