Effects of multistrain probiotic-containing yogurt on second-line triple therapy for Helicobacter pylori infection

Background and Aims: The adjuvant effects of probiotic-containing yogurt on second-line triple therapy for Helicobacter pylori (H. pylori) infection have not been evaluated. Methods: A total of 337 patients with persistent H. pylori infection, after first-line triple therapy, were randomly assigned to receive either triple therapy with (yogurt group, n = 151) or without (control group, n = 186) Will yogurt. Triple therapy consisted of 400 mg moxifloxacin q.d., 1000 mg amoxicillin b.i.d., and 20 mg esomeprazole b.i.d. for 14 days. Will yogurt contains Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium longum, and Streptococcus thermophilus. H. pylori eradication was evaluated by the 13C-urea breath test, histology, or the rapid urease test. Results: The eradication rates by intention-to-treat analysis were 66.7% and 68.9% in the control and yogurt groups, respectively (P = 0.667). The eradication rates by per-protocol analysis were 78.5% and 86% in the control and the yogurt groups, respectively (P = 0.110). The adverse event rates were 25.3% and 28.5% in the control group and yogurt group, respectively (P = 0.508). Conclusions: The addition of yogurt containing probiotics to moxifloxacin-containing second-line treatment neither improved H. pylori eradication rates nor reduced the adverse events of treatment.