Lactobacillus supplementation for Helicobacter pylori eradication in children: A language-inclusive systematic review and meta-analysis of efficacy and safety

Table 1 Main characteristics of the studies included in the systematic review and meta-analysis

Ref.	Country	No. of patients (Exp/Con)	Age, [median or mean (range)], years	Eradication regimen	Lactobacillus spp. regimen	Diagnostic methods of H. pylori
						Initial	Rechecking
Li and Zhou[31]	China	164 (82/82)	11.2 ± 2.6	Esomeprazole + amoxicillin + clarithromycin, 14 days	Compound of lactobacilli, 3 g daily, 14 days	UBT, histology	NR
Lionetti et al[36]	Italy	40 (20/20)	12.3 (3.3-18)	Omeprazole, 10 days + amoxicillin, 5 days and clarithromycin + tinidazole, 5 days	L. reuteri ATCC 55730, 108 CFU once daily, 20 days	UBT, histology, RUT	UBT
Meng[27]	China	70 (35/35)	1.7 ± 0.6 (0.6-3)	Rabeprazole + furazolidone + amoxicillin	Compound of lactobacilli, 3 times a day	UBT, histology	NR
Pan et al[28]	China	79 (38/41)	< 18	Omeprazole + amoxicillin + clarithromycin, 14 days	L. acidophilus, once daily, 28 days	UBT, histology, RUT	UBT
Plewinska et al[33]	Poland	60 (30/30)	14.1 ± 2.3 (8.8-18.3)	Omeprazole + amoxicillin + clarithromycin, 10 days	L. acidophilus R0052, L. Rhamnosus R0011, 6 × 109 CFU once daily, 30 days	Histology, RUT	Histology, RUT
Shahraki et al[35]	Iran	50 (25/25)	8.5 ± 2.5 (5-14)	Omeprazole + amoxicillin + clarithromycin, 14 days	L. reuteri, 108 CFU once daily, 28 days	Histology, SAT	UBT
Sun[26]	China	96 (48/48)	9.2 ± 0.2 (3-14)	Omeprazole + amoxicillin + clarithromycin, 10 days	L. acidophilus, 0.5 g daily, 10 days	UBT, histology	UBT, histology
Sýkora et al[34]	Czech Republic	86 (39/47)	< 18	Omeprazole + amoxicillin + clarithromycin, 7 days	L. casei DN 114 001, 1010 CFU daily, 14 days	Histology, RUT, SAT	UBT, SAT
Szajewska et al[32]	Poland	83 (44/39)	(5-17)	Omeprazole + amoxicillin + clarithromycin, 7 days	Lactobacillus GG, 109 CFU once daily, 7 days	UBT. Histology, RUT	UBT
Wang and Feng[29]	China	104 (52/52)	8.3 ± 1.2 (3-13)	Omeprazole + amoxicillin + clarithromycin, 7 days	L. acidophilus, 0.5 g daily, 7 days	UBT	UBT
Wang and Li[25]	China	96 (48/48)	< 18	Omeprazole + amoxicillin + clarithromycin, 10 days	L. acidophilus, 0.5 g daily, 28 days	UBT	UBT
Wang et al[30]	China	84 (42/42)	(3-13)	Omeprazole + amoxicillin + clarithromycin, 14 days	L. acidophilus, 0.5 g daily, 14 days	UBT, histology	UBT
Zhu et al[24]	China	211 (109/102)	< 18	Omeprazole 10 days + amoxicillin-clavulanate, 5 days, and clarithromycin + metronidazole, 5 days	Compound of lactobacilli, 10 days	UBT	UBT
Zhu et al[24]	China	205 (105/100)	< 18	Omeprazole + amoxicillin-clavulanate + clarithromycin, 14 days	Compound of lactobacilli, 14 days	UBT	UBT

CFU: Colony-forming unit; Con: Control group (standard triple therapy); Exp: Experimental group (Lactobacillus spp. + standard triple therapy); NR: Not reported; PPI: Proton pump inhibitor; RUT: Rapid urease test; SAT: Stool antigen test; UBT: Urea breath test; L. reuteri: Lactobacillus reuteri; Lactobacillus spp.: Lactobacillus species; L. acidophilus: Lactobacillus acidophilus; H. pylori: Helicobacter pylori.