Further trials of probiotic H. pylori infection control in children needed

MedWire News: Researchers have called for further trials into the use of probiotics for prevention and eradication of Helicobacter pylori infection in children, following the results of a pilot study.

The team tested whether long-time administration of the Lactobacillus gasseri OLL2716 (LG21) strain could eradicate or prevent H. pylori infection in 440 asymptomatic children, aged 5 to 7 years, attending a kindergarten in Thailand.

Guardians of the 132 children with a positive H. pylori stool antigen (HpSA) test were asked to chose whether their child received 1.6 to 2.0 g daily of ordinary cheese or one containing approximately 5 × 10⁸ viable LG21 colony-forming units/g.

Randomized allocation was not performed due to ethical considerations, the researchers say. Overall, 62% of these children completed the study, of who 29.3% tested negative with the HpSA test at 12 months.

The 308 H. pylori-negative children were randomly assigned to receive active and placebo treatment groups containing the probiotic and ordinary cheese, respectively.

Overall, 79% of the 156 children the active arm and 81% of the 122 in the placebo arm completed the study.

In the per-protocol analysis 4.1% in the active arm and 8.1% in the placebo arms were HpSA-positive at 12 months; although the decrease in infection with the probiotic cheese was around 50%, the difference did not register as statistically significant.

The eradication rate with probiotics was not at all comparable to that observed after antibiotic treatment, acknowledge Yasuhiro Koga (Tokai University School of Medicine, Isehara, Japan) and colleagues in the journal Helicobacter.

“However, in a large scale solution for the control of H. pylori infection, accomplishment of eradication in around 20% of H. pylori-infected children in our study is thought to result in significantly decreasing the burden of antibiotic treatment in the children, especially in highly prevalent areas,” they say.