{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:27:23Z","timestamp":1794324443318,"version":"4.9.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Supplementing\n H. pylori<\/jats:italic>\n treatment with probiotics like Lactobacillus has become an essential approach due to the possible adverse effects of antibiotic therapy and the need to increase overall eradication rates. Although several types of Lactobacillus strains as probiotics were efficient in treating\n H. pylori<\/jats:italic>\n , their relative efficiency in treating\n H. pylori<\/jats:italic>\n was uncertain. A survey of databases, including PubMed, Cochrane, Google Scholar, Scopus, and\n Clinicaltrials.gov<\/jats:ext-link>\n , retrieved 52 Randomized Controlled Trials (RCTs), with 14 meeting the criteria for RCTs on Lactobacillus supplementation (LS) as an adjunct therapy compared to placebo in adult\n H. pylori<\/jats:italic>\n patients. Analyses were conducted using RevMan5.3, Cochrane Risk of Bias Tool, Comprehensive Meta\u2010Analysis Software, and GRADEpro. Fourteen RCTs, including 2054 patients with more than ten different probiotics, were included in this analysis. The LS group showed significantly higher\n H. pylori<\/jats:italic>\n eradication rates [RR\u2009=\u20091.04 (95% CI: 1.01, 1.07;\n p<\/jats:italic>\n \u2009=\u20090.009;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%); (high certainty)], decreased AEs including vomiting [RR\u2009=\u20090.82 (95% CI: 0.48, 1.41;\n p<\/jats:italic>\n \u2009=\u20090.48;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200919%); (high certainty)], diarrhea [RR\u2009=\u20090.45 (95% CI: 0.26, 0.80;\n p<\/jats:italic>\n \u2009=\u20090.007;\n I<\/jats:italic>\n \u00b2\u2009=\u200955%); (high certainty)], abdominal pain [RR\u2009=\u20090.73 (95% CI: 0.28, 1.93;\n p<\/jats:italic>\n \u2009=\u20090.53;\n I<\/jats:italic>\n \u00b2\u2009=\u200966%); (high certainty)], anorexia [RR\u2009=\u20090.79 (95% CI: 0.23, 2.64;\n p<\/jats:italic>\n \u2009=\u20090.70;\n I<\/jats:italic>\n \u00b2\u2009=\u20090%); (high certainty)], constipation [RR\u2009=\u20091.02 (95% CI: 0.42, 2.50;\n p<\/jats:italic>\n \u2009=\u20090.96;\n I<\/jats:italic>\n \u00b2\u2009=\u20090%); (high certainty)], rash [RR\u2009=\u20091.51 (95% CI: 0.57, 3.98;\n p<\/jats:italic>\n \u2009=\u20090.41;\n I<\/jats:italic>\n \u00b2\u2009=\u20090%); (high certainty)], taste disturbance [RR\u2009=\u20090.64 (95% CI: 0.44, 0.92;\n p<\/jats:italic>\n \u2009=\u20090.02;\n I<\/jats:italic>\n \u00b2\u2009=\u200951%); (moderate certainty)], and reduction of gastrointestinal symptoms including abdominal pain [SMD\u2009=\u2009\u22120.19 (95% CI: \u22120.46, 0.09;\n p<\/jats:italic>\n \u2009=\u20090.18; I\u00b2\u2009=\u2009%); (moderate certainty)]. None of the included RCTs depicted a high risk of bias. Lactobacillus added to triple or quadruple therapy increased eradication rates, but improvements in adverse effects and gastrointestinal symptoms were not significant. Multiple different strains limited assessment of individual effectiveness, preventing firm conclusions about the specific impact of each Lactobacillus type.\n <\/jats:p>","DOI":"10.1002\/mbo3.70166","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T05:32:26Z","timestamp":1764653546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials on the Benefits of Using Lactobacillus Supplements as an Adjunct Treatment for\n Helicobacter pylori<\/i>\n Eradication"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3592-7493","authenticated-orcid":false,"given":"Asma","family":"Azam","sequence":"first","affiliation":[{"name":"Karachi Medical & Dental College Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5893-3281","authenticated-orcid":false,"given":"Muhammad Abdul Muqtadir","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Quaid\u2010e\u2010Azam Medical College Bahawalpur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7692-6795","authenticated-orcid":false,"given":"Hafiz Shahbaz","family":"Zahoor","sequence":"additional","affiliation":[{"name":"Quaid\u2010e\u2010Azam Medical College Bahawalpur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5638-9717","authenticated-orcid":false,"given":"Syeda Malaika","family":"Raza","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2353-0276","authenticated-orcid":false,"given":"Muhammad Mohsin","family":"Khan","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2317-6866","authenticated-orcid":false,"given":"Umaimah","family":"Naeem","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5262-539X","authenticated-orcid":false,"given":"Syed","family":"Atif","sequence":"additional","affiliation":[{"name":"Mary Washington Family Medicine Residency Program Fredericksburg Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5812-8822","authenticated-orcid":false,"given":"Abdul","family":"Waheed","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Dignity Health Medical Group Arizona"},{"name":"Creighton University School of Medicine Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.1989.tb05105.x"},{"key":"e_1_2_10_3_1","unstructured":"Cochrane Handbook for Systematic Reviews of Interventions. n.d. 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McMaster University and Evidence Prime.https:\/\/gradepro.org."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.022"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12299"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.03.010"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:DDAS.0000037794.02040.c2"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2015.2174"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01169.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327745"},{"issue":"3","key":"e_1_2_10_13_1","first-page":"219","article-title":"Peptic Ulcer Disease and Helicobacter Pylori Infection","volume":"115","author":"Narayanan M.","year":"2018","journal-title":"Missouri Medicine"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16060778"},{"key":"e_1_2_10_16_1","unstructured":"Review Manager RevMan Computer program. 2020. 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