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World J Gastroenterol. Jan 21, 2014; 20(3): 673-683
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.673
Probiotics for the treatment of Helicobacter pylori infection in children
Lucia Pacifico, John Frederick Osborn, Enea Bonci, Sara Romaggioli, Rossella Baldini, Claudio Chiesa
Lucia Pacifico, Sara Romaggioli, Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 324 00161 Rome, Italy
John Frederick Osborn, Department of Health Sciences and Infectious Diseases, Sapienza University of Rome, 324 00161 Rome, Italy
Enea Bonci, Department of Experimental Medicine, Sapienza University of Rome, 324 00161 Rome, Italy
Rossella Baldini, Department of Human Anatomy, Sapienza University of Rome, 324 00161 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 100 00133 Rome, Italy
Author contributions: Pacifico L, Osborn JF, Bonci E and Chiesa C designed the study, analyzed the data and wrote the manuscript; Romaggioli S and Baldini R collected the data; all the authors participated in the critical review and in the final approval of the manuscript.
Correspondence to: Lucia Pacifico, MD, Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Viale Regina Elena, 324 00161 Rome, Italy. lucia.pacifico@uniroma1.it
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: September 19, 2013
Revised: October 25, 2013
Accepted: December 3, 2013
Published online: January 21, 2014
Processing time: 151 Days and 23 Hours
Abstract

The combination of a proton pump inhibitor and two antibiotics (clarithromycin plus amoxicillin or metronidazole) has been the recommended first-line therapy since the first guidelines for Helicobacter pylori (H. pylori) infection in children were published. In recent years, the success of eradication therapies has declined, in part due to the development of H. pylori resistant strains. Alternative anti-H. pylori treatments are currently becoming more popular than the traditional eradication methods. Components that may be used either as a monotherapy or, in combination with antimicrobials, resulting in a more effective anti-H. pylori therapy have been investigated in depth by several researchers. One of the potential therapies is probiotic cultures; promising results have been observed in initial studies with numerous probiotic strains. Nevertheless, many questions remain unanswered. In this article, we comprehensively review the possible mechanisms of action of probiotics on H. pylori infection, and present the results of published studies using probiotics as possible agents to control H. pylori infection in children. The effect of the addition of probiotics to the standard H. pylori eradication therapy for the prevention of antibiotic associated side-effects is also discussed.

Keywords: Helicobacter pylori; Children; Probiotics; Eradication treatment; Prevention

Core tip: Because of the decrease in the Helicobacter pylori (H. pylori) eradication rate after standard triple therapy with a proton pump inhibitor and two antibiotics, alternative therapies have recently received attention. In this article, we comprehensively review the possible mechanisms of action of probiotics on H. pylori infection, and present the results of the published studies using probiotics as possible agents to control H. pylori growth in children. The effect of the addition of probiotics to the standard H. pylori eradication therapy for the prevention of antibiotic associated side-effects is also discussed.