{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:53:13Z","timestamp":1791276793248,"version":"4.1.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Pharmacol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      eradication therapies supplemented with\n                      <jats:italic>Lactobacillus spp.<\/jats:italic>\n                      may improve eradication rates and reduce adverse events by modulating gut microbiota and immune responses. This meta-analysis aimed to evaluate the efficacy and safety of Lactobacillus-supplemented\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      eradication therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically searched for randomized controlled trials (RCTs) comparing standard\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      eradication therapy with and without\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      in PubMed, Embase, and Cochrane Library up to August 2026. The primary outcome was eradication success, and the secondary outcome was adverse events. We calculated pooled risk ratios (RR) with 95% confidence intervals (CIs) using a random-effects model. We also estimated the number needed to treat (NNT) for eradication success and conducted subgroup analyses by antibiotic therapy type, duration of antibiotic treatment, Lactobacillus strain type, Lactobacillus dosage, period of Lactobacillus use, probiotic formulation, geographical region, and age range. This review was registered in PROSPERO (CRD42024611138).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two RCTs (4,010 patients) were included.\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      -supplemented eradication therapy improved eradication success (RR 1.10; 95%CI 1.05\u20131.14; NNT 13) and reduced the risk of adverse events (RR 0.70; 95%CI 0.58\u20130.84). Subgroup analyses showed significant differences in eradication success by antibiotic regimen and in adverse event risk by age group. Improved eradication success with\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      -supplemented eradication therapy was observed only with triple therapy regimens, whereas adverse event risk was reduced only among adults.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      -supplemented eradication therapy was associated with a 10% relative increase in\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      eradication success and a 30% relative reduction in treatment-related adverse events compared with the control group.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00228-026-04186-5","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:54:47Z","timestamp":1790387687000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Lactobacillus-supplemented eradication therapy for Helicobacter pylori: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1007","volume":"82","author":[{"given":"Karollyna M. Henry","family":"Moore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Santo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica Uchoa","family":"Holanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica Luciana","family":"Nau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-4368","authenticated-orcid":false,"given":"Gilmara Coelho","family":"Meine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"4186_CR1","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S2468-1253(23)00070-5","volume":"8","author":"Y Li","year":"2023","unstructured":"Li Y, Choi H, Leung K, Jiang F, Graham DY, Leung WK (2023) Global prevalence of Helicobacter pylori infection between 1980 and 2022: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 8:553\u2013564. https:\/\/doi.org\/10.1016\/S2468-1253(23)00070-5","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"4186_CR2","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1136\/gutjnl-2022-327745","volume":"71","author":"P Malfertheiner","year":"2022","unstructured":"Malfertheiner P, Megraud F, Rokkas T et al (2022) Management of Helicobacter pylori infection: the Maastricht VI\/Florence consensus report. Gut 71:1724\u20131762. https:\/\/doi.org\/10.1136\/gutjnl-2022-327745","journal-title":"Gut"},{"key":"4186_CR3","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1080\/17474124.2024.2435520","volume":"18","author":"DY Graham","year":"2024","unstructured":"Graham DY, Rokkas T (2024) Overcoming the effects of increasing antimicrobial resistance on Helicobacter pylori therapy. Expert Rev Gastroenterol Hepatol 18:705\u2013711. https:\/\/doi.org\/10.1080\/17474124.2024.2435520","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"4186_CR4","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.1007\/s12602-024-10396-z","volume":"17","author":"D Dash","year":"2025","unstructured":"Dash D, Mishra V, Panda MK, Pathak SK (2025) Effects of Lactobacillus spp. on Helicobacter pylori: a promising frontier in the era of antibiotic resistance. Probiotics Antimicrob Proteins 17:2653\u20132672. https:\/\/doi.org\/10.1007\/s12602-024-10396-z","journal-title":"Probiotics Antimicrob Proteins"},{"key":"4186_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s40795-018-0257-4","volume":"4","author":"M Buckley","year":"2018","unstructured":"Buckley M, Lacey S, Doolan A et al (2018) The effect of Lactobacillus reuteri supplementation in Helicobacter pylori infection: a placebo-controlled, single-blind study. BMC Nutr 4:48. https:\/\/doi.org\/10.1186\/s40795-018-0257-4","journal-title":"BMC Nutr"},{"key":"4186_CR6","doi-asserted-by":"publisher","DOI":"10.3390\/foods13121851","volume":"13","author":"H Yang","year":"2024","unstructured":"Yang H, Lin Y, Ma Y et al (2024) Screening probiotics for anti-Helicobacter pylori and investigating the effect of probiotics on patients with Helicobacter pylori infection. Foods 13:1851. https:\/\/doi.org\/10.3390\/foods13121851","journal-title":"Foods"},{"key":"4186_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","author":"JAC Sterne","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. https:\/\/doi.org\/10.1136\/bmj.l4898","journal-title":"BMJ"},{"key":"4186_CR8","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","volume":"64","author":"G Guyatt","year":"2011","unstructured":"Guyatt G, Oxman AD, Akl EA et al (2011) GRADE guidelines: 1. Introduction\u2014GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383\u2013394. https:\/\/doi.org\/10.1016\/j.jclinepi.2010.04.026","journal-title":"J Clin Epidemiol"},{"key":"4186_CR9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"4186_CR10","unstructured":"Deeks JJ, Higgins JPT, Altman DG, McKenzie JE, Veroniki AA (2024) Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ (eds) Cochrane handbook for systematic reviews of interventions, version 6.5. Cochrane"},{"key":"4186_CR11","doi-asserted-by":"publisher","first-page":"2859","DOI":"10.31557\/APJCP.2019.20.9.2859","volume":"20","author":"P Poonyam","year":"2019","unstructured":"Poonyam P, Chotivitayatarakorn P, Vilaichone RK (2019) High effectiveness of 14-day high-dose PPI-bismuth-containing quadruple therapy with probiotics supplement for Helicobacter pylori eradication: a double-blind randomized placebo-controlled study. Asian Pac J Cancer Prev 20:2859\u20132864. https:\/\/doi.org\/10.31557\/APJCP.2019.20.9.2859","journal-title":"Asian Pac J Cancer Prev"},{"key":"4186_CR12","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1046\/j.1365-2036.2001.00923.x","volume":"15","author":"A Armuzzi","year":"2001","unstructured":"Armuzzi A, Cremonini F, Bartolozzi F et al (2001) The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther 15:163\u2013169. https:\/\/doi.org\/10.1046\/j.1365-2036.2001.00923.x","journal-title":"Aliment Pharmacol Ther"},{"key":"4186_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000051865","volume":"63","author":"A Armuzzi","year":"2001","unstructured":"Armuzzi A, Cremonini F, Ojetti V et al (2001) Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study. Digestion 63:1\u20137. https:\/\/doi.org\/10.1159\/000051865","journal-title":"Digestion"},{"key":"4186_CR14","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1046\/j.1365-2036.2000.00885.x","volume":"14","author":"F Canducci","year":"2000","unstructured":"Canducci F, Armuzzi A, Cremonini F et al (2000) A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther 14:1625\u20131629. https:\/\/doi.org\/10.1046\/j.1365-2036.2000.00885.x","journal-title":"Aliment Pharmacol Ther"},{"key":"4186_CR15","doi-asserted-by":"publisher","first-page":"2744","DOI":"10.1016\/S0002-9270(02)05480-1","volume":"97","author":"F Cremonini","year":"2002","unstructured":"Cremonini F, Di Caro S, Covino M et al (2002) Effect of different probiotic preparations on anti-Helicobacter pylori therapy-related side effects: a parallel group, triple-blind, placebo-controlled study. Am J Gastroenterol 97:2744\u20132749. https:\/\/doi.org\/10.1016\/S0002-9270(02)05480-1","journal-title":"Am J Gastroenterol"},{"key":"4186_CR16","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/s10096-010-1119-4","volume":"30","author":"JA da Silva Medeiros","year":"2011","unstructured":"da Silva Medeiros JA, Gon\u00e7alves TMFO, Boyanova L et al (2011) Evaluation of Helicobacter pylori eradication by triple therapy plus Lactobacillus acidophilus compared to triple therapy alone. Eur J Clin Microbiol Infect Dis 30:555\u2013559. https:\/\/doi.org\/10.1007\/s10096-010-1119-4","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"4186_CR17","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1111\/j.1440-1746.2011.06985.x","volume":"27","author":"R Deguchi","year":"2012","unstructured":"Deguchi R, Nakaminami H, Rimbara E et al (2012) Effect of pretreatment with Lactobacillus gasseri OLL2716 on first-line Helicobacter pylori eradication therapy. J Gastroenterol Hepatol 27:888\u2013892. https:\/\/doi.org\/10.1111\/j.1440-1746.2011.06985.x","journal-title":"J Gastroenterol Hepatol"},{"key":"4186_CR18","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12659","author":"MP Dore","year":"2019","unstructured":"Dore MP, Bibb\u00f2 S, Loria M et al (2019) Twice-a-day PPI, tetracycline, metronidazole quadruple therapy with Pylera\u00ae or Lactobacillus reuteri for treatment-na\u00efve or for retreatment of Helicobacter pylori: two randomized pilot studies. Helicobacter. https:\/\/doi.org\/10.1111\/hel.12659","journal-title":"Helicobacter"},{"key":"4186_CR19","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/1756283X13503514","volume":"7","author":"MH Emara","year":"2014","unstructured":"Emara MH, Mohamed SY, Abdel-Aziz HR (2014) Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial. Th Adv Gastroenterol 7:4\u201313. https:\/\/doi.org\/10.1177\/1756283X13503514","journal-title":"Th Adv Gastroenterol"},{"key":"4186_CR20","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1097\/MCG.0000000000000007","volume":"48","author":"R Francavilla","year":"2014","unstructured":"Francavilla R, Polimeno L, Demichina A et al (2014) Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. J Clin Gastroenterol 48:407\u2013413. https:\/\/doi.org\/10.1097\/MCG.0000000000000007","journal-title":"J Clin Gastroenterol"},{"key":"4186_CR21","doi-asserted-by":"publisher","unstructured":"Fu Y, Dong J, Xu L et al (2026) Adjuvant Lactiplantibacillus plantarum Lp05 modulates gut microbiota and alleviates symptoms during Helicobacter pylori eradication. Microbiol Spectr 14. https:\/\/doi.org\/10.1128\/spectrum.00182-26","DOI":"10.1128\/spectrum.00182-26"},{"key":"4186_CR22","doi-asserted-by":"publisher","first-page":"106539","DOI":"10.1016\/j.jinf.2025.106539","volume":"91","author":"X Han","year":"2025","unstructured":"Han X, Liu H, Zhang K et al (2025) Lactiplantibacillus plantarum MH-301 reduces Helicobacter pylori treatment-related adverse events via gut-vaginal axis: a randomized, double-blind, placebo-controlled trial. J Infect 91:106539. https:\/\/doi.org\/10.1016\/j.jinf.2025.106539","journal-title":"J Infect"},{"key":"4186_CR23","doi-asserted-by":"publisher","DOI":"10.1111\/hel.13017","author":"NI Ismail","year":"2023","unstructured":"Ismail NI, Nawawi KNM, Hsin DCC et al (2023) Probiotic containing Lactobacillus reuteri DSM 17648 as an adjunct treatment for Helicobacter pylori infection: a randomized, double-blind, placebo-controlled trial. Helicobacter. https:\/\/doi.org\/10.1111\/hel.13017","journal-title":"Helicobacter"},{"key":"4186_CR24","doi-asserted-by":"publisher","unstructured":"Ivashkin V, Maev I, Poluektova E et al (2024) Efficacy and safety of postbiotic (metabiotic) contained inactivated Lactobacillus reuteri (Limosilactobacillus reuteri) DSM 17648 as adjuvant therapy in the eradication of Helicobacter pylori in adults with functional dyspepsia: a randomized double-blind trial. Clin Transl Gastroenterol 15. https:\/\/doi.org\/10.14309\/ctg.0000000000000750","DOI":"10.14309\/ctg.0000000000000750"},{"key":"4186_CR25","doi-asserted-by":"publisher","first-page":"784","DOI":"10.53555\/jptcp.v30i19.3755","volume":"30","author":"L Kamani","year":"2023","unstructured":"Kamani L, Akmal M, Rahat A et al (2023) Improvement in eradication of Helicobacter pylori infection with addition of Lactobacillus reuteri: a randomized controlled trial. J Popul Ther Clin Pharmacol 30:784\u2013794. https:\/\/doi.org\/10.53555\/jptcp.v30i19.3755","journal-title":"J Popul Ther Clin Pharmacol"},{"key":"4186_CR26","doi-asserted-by":"publisher","first-page":"1245993","DOI":"10.3389\/fgstr.2023.1245993","volume":"2","author":"A Kiattiweerasak","year":"2023","unstructured":"Kiattiweerasak A, Aumpan N, Chonprasertsuk S et al (2023) Efficacy and safety of Lacticaseibacillus rhamnosus R0011 and Lactobacillus helveticus R0052 as an adjuvant for Helicobacter pylori eradication: a double-blind, randomized, placebo-controlled study. Front Gastroenterol 2:1245993. https:\/\/doi.org\/10.3389\/fgstr.2023.1245993","journal-title":"Front Gastroenterol"},{"key":"4186_CR27","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1111\/j.1365-2036.2006.03145.x","volume":"24","author":"E Lionetti","year":"2006","unstructured":"Lionetti E, Miniello VL, Castellaneta SP et al (2006) Lactobacillus reuteri therapy to reduce side effects during anti-Helicobacter pylori treatment in children: a randomized placebo-controlled trial. Aliment Pharmacol Ther 24:1461\u20131468. https:\/\/doi.org\/10.1111\/j.1365-2036.2006.03145.x","journal-title":"Aliment Pharmacol Ther"},{"key":"4186_CR28","first-page":"1087","volume":"28","author":"F Ma","year":"2015","unstructured":"Ma F, Zhou C, Wang J et al (2015) Probiotics in the treatment of peptic ulcer infected by Helicobacter pylori and its safety. Pak J Pharm Sci 28:1087\u20131090","journal-title":"Pak J Pharm Sci"},{"key":"4186_CR29","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.ajg.2022.10.004","volume":"24","author":"M Mohtasham","year":"2023","unstructured":"Mohtasham M, Joukar F, Maroufizadeh S et al (2023) Lactobacillus reuteri compared with placebo as an adjuvant in quadruple therapy for Helicobacter pylori eradication: a randomized, double-blind, controlled trial. Arab J Gastroenterol 24:40\u201344. https:\/\/doi.org\/10.1016\/j.ajg.2022.10.004","journal-title":"Arab J Gastroenterol"},{"key":"4186_CR30","doi-asserted-by":"publisher","first-page":"89","DOI":"10.17235\/reed.2021.7931\/2021","volume":"114","author":"C Moreno M\u00e1rquez","year":"2022","unstructured":"Moreno M\u00e1rquez C, Fern\u00e1ndez \u00c1lvarez P, Vald\u00e9s Delgado T et al (2022) Randomized, double-blind, placebo-controlled clinical trial on the usefulness of probiotic Lactobacillus reuteri in bismuth-containing quadruple eradication therapy for infection with Helicobacter pylori. Rev Esp Enferm Dig 114:89\u201395. https:\/\/doi.org\/10.17235\/reed.2021.7931\/2021","journal-title":"Rev Esp Enferm Dig"},{"key":"4186_CR31","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1450414","volume":"15","author":"Y Niu","year":"2024","unstructured":"Niu Y, Li J, Qian H et al (2024) Evaluation of efficacy and safety of Lacticaseibacillus rhamnosus LRa05 in the eradication of Helicobacter pylori: a randomized, double-blind, placebo-controlled trial. Front Immunol 15:1450414. https:\/\/doi.org\/10.3389\/fimmu.2024.1450414","journal-title":"Front Immunol"},{"key":"4186_CR32","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/740381","author":"V Ojetti","year":"2012","unstructured":"Ojetti V, Bruno G, Ainora ME et al (2012) Impact of Lactobacillus reuteri supplementation on anti-Helicobacter pylori levofloxacin-based second-line therapy. Gastroenterol Res Pract. https:\/\/doi.org\/10.1155\/2012\/740381","journal-title":"Gastroenterol Res Pract"},{"key":"4186_CR33","doi-asserted-by":"publisher","first-page":"6698","DOI":"10.3748\/wjg.v21.i21.6698","volume":"21","author":"OA Paoluzi","year":"2015","unstructured":"Paoluzi OA, Del Vecchio Blanco G, Visconti E et al (2015) Low efficacy of levofloxacin-doxycycline-based third-line triple therapy for Helicobacter pylori eradication in Italy. World J Gastroenterol 21:6698\u20136705. https:\/\/doi.org\/10.3748\/wjg.v21.i21.6698","journal-title":"World J Gastroenterol"},{"key":"4186_CR34","doi-asserted-by":"publisher","first-page":"151","DOI":"10.9734\/jpri\/2021\/v33i52B33611","volume":"33","author":"K Parth","year":"2021","unstructured":"Parth K, Prudhivi R, Palatheeya S et al (2021) Efficacy of Lactobacillus reuteri supplementation in eradication of H. pylori: a comparison study with triple drug therapy. J Pharm Res Int 33:151\u2013159. https:\/\/doi.org\/10.9734\/jpri\/2021\/v33i52B33611","journal-title":"J Pharm Res Int"},{"key":"4186_CR35","first-page":"333","volume":"75","author":"JE Sahag\u00fan-Flores","year":"2007","unstructured":"Sahag\u00fan-Flores JE, L\u00f3pez-Pe\u00f1a LS, Jaimes JDLCR et al (2007) Eradication of Helicobacter pylori: triple treatment scheme plus Lactobacillus vs. triple treatment alone. Cir Cir 75:333\u2013336","journal-title":"Cir Cir"},{"key":"4186_CR36","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.42101","author":"T Shahraki","year":"2017","unstructured":"Shahraki T, Shahraki M, Shafighi Shahri E et al (2017) No significant impact of Lactobacillus reuteri on eradication of Helicobacter pylori in children: double-blind randomized clinical trial. Iran Red Crescent Med J. https:\/\/doi.org\/10.5812\/ircmj.42101","journal-title":"Iran Red Crescent Med J"},{"key":"4186_CR37","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1097\/01.mcg.0000173855.77191.44","volume":"39","author":"J S\u00fdkora","year":"2005","unstructured":"S\u00fdkora J, Valeckov\u00e1 K, Amlerov\u00e1 J et al (2005) Effects of a specially designed fermented milk product containing probiotic Lactobacillus casei DN-114 001 and the eradication of H. pylori in children: a prospective randomized double-blind study. J Clin Gastroenterol 39:692\u2013698. https:\/\/doi.org\/10.1097\/01.mcg.0000173855.77191.44","journal-title":"J Clin Gastroenterol"},{"key":"4186_CR38","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1097\/MPG.0b013e318182e716","volume":"48","author":"H Szajewska","year":"2009","unstructured":"Szajewska H, Albrecht P, Topczewska-Cabanek A (2009) Randomized, double-blind, placebo-controlled trial: effect of Lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr 48:431\u2013436. https:\/\/doi.org\/10.1097\/MPG.0b013e318182e716","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4186_CR39","unstructured":"Tursi A, Brandimarte G, Giorgetti GM et al (2004) Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Med Sci Monit 10\u2013CR666"},{"key":"4186_CR40","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12856","author":"C Yang","year":"2021","unstructured":"Yang C, Liang L, Lv P et al (2021) Effects of non-viable Lactobacillus reuteri combining with 14-day standard triple therapy on Helicobacter pylori eradication: a randomized double-blind placebo-controlled trial. Helicobacter. https:\/\/doi.org\/10.1111\/hel.12856","journal-title":"Helicobacter"},{"key":"4186_CR41","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-025-01124-6","volume":"24","author":"Y Zhao","year":"2025","unstructured":"Zhao Y, Niu X, Zhang Y et al (2025) Impact of supplementing Limosilactobacillus fermentum MN-LF23 on the eradication of Helicobacter pylori with 14-day standard quadruple therapy: a randomized, double-blind, placebo-controlled trial. Nutr J 24:106. https:\/\/doi.org\/10.1186\/s12937-025-01124-6","journal-title":"Nutr J"},{"issue":"Suppl 3","key":"4186_CR42","first-page":"123","volume":"57","author":"W Ziemniak","year":"2006","unstructured":"Ziemniak W (2006) Efficacy of Helicobacter pylori eradication taking into account its resistance to antibiotics. J Physiol Pharmacol 57(Suppl 3):123\u2013141","journal-title":"J Physiol Pharmacol"},{"key":"4186_CR43","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12101986","volume":"12","author":"CMA Savitri","year":"2024","unstructured":"Savitri CMA, Fauzia KA, Alfaray RI et al (2024) Opportunities for Helicobacter pylori eradication beyond conventional antibiotics. Microorganisms 12:1986. https:\/\/doi.org\/10.3390\/microorganisms12101986","journal-title":"Microorganisms"},{"key":"4186_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/ijms252212222","volume":"25","author":"P Krzy\u017cek","year":"2024","unstructured":"Krzy\u017cek P (2024) Helicobacter pylori efflux pumps: a double-edged sword in antibiotic resistance and biofilm formation. Int J Mol Sci 25:12222. https:\/\/doi.org\/10.3390\/ijms252212222","journal-title":"Int J Mol Sci"},{"key":"4186_CR45","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s12602-024-10348-7","volume":"17","author":"S Mal","year":"2025","unstructured":"Mal S, Das TK, Pradhan S et al (2025) Probiotics as a therapeutic approach for non-infectious gastric ulcer management: a comprehensive review. Probiotics Antimicrob Proteins 17:393\u2013418. https:\/\/doi.org\/10.1007\/s12602-024-10348-7","journal-title":"Probiotics Antimicrob Proteins"},{"key":"4186_CR46","doi-asserted-by":"publisher","DOI":"10.1177\/17562848241258021","volume":"17","author":"M Li","year":"2024","unstructured":"Li M, Wang X, Dong X et al (2024) Lactobacillus reuteri compared with placebo as an adjuvant in Helicobacter pylori eradication therapy: a meta-analysis of randomized controlled trials. Therap Adv Gastroenterol 17:17562848241258021. https:\/\/doi.org\/10.1177\/17562848241258021","journal-title":"Therap Adv Gastroenterol"},{"key":"4186_CR47","doi-asserted-by":"publisher","unstructured":"Yu M, Zhang R, Ni P et al (2019) Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori eradication: a meta-analysis of randomized controlled trials. PLoS ONE 14. https:\/\/doi.org\/10.1371\/journal.pone.0223309","DOI":"10.1371\/journal.pone.0223309"},{"key":"4186_CR48","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70006","author":"V Mishra","year":"2024","unstructured":"Mishra V, Dash D, Panda AK et al (2024) Efficacy of Lactobacillus spp. supplementation in Helicobacter pylori eradication: a systematic meta-analysis of randomized controlled trials with trial sequential analysis. Helicobacter. https:\/\/doi.org\/10.1111\/hel.70006","journal-title":"Helicobacter"},{"key":"4186_CR49","doi-asserted-by":"publisher","first-page":"932331","DOI":"10.3389\/fmicb.2022.932331","volume":"13","author":"P Marinelli","year":"2022","unstructured":"Marinelli P, Scalese G, Covelli A et al (2022) Lactobacillus rhamnosus GG supplementation on eradication rate and dyspepsia in Helicobacter pylori infection treated with three-in-one bismuth quadruple therapy. Front Microbiol 13:932331. https:\/\/doi.org\/10.3389\/fmicb.2022.932331","journal-title":"Front Microbiol"},{"key":"4186_CR50","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/00042737-200101000-00005","volume":"13","author":"CP Felley","year":"2001","unstructured":"Felley CP, Corth\u00e9sy-Theulaz I, Rivero JL et al (2001) Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol 13:25\u201329. https:\/\/doi.org\/10.1097\/00042737-200101000-00005","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"4186_CR51","doi-asserted-by":"publisher","DOI":"10.3390\/nu14142789","volume":"14","author":"MP Dore","year":"2022","unstructured":"Dore MP, Sau R, Niolu C et al (2022) Metagenomic changes of gut microbiota following treatment of Helicobacter pylori infection with a simplified low-dose quadruple therapy with bismuth or Lactobacillus reuteri. Nutrients 14:2789. https:\/\/doi.org\/10.3390\/nu14142789","journal-title":"Nutrients"},{"key":"4186_CR52","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/j.1523-5378.2008.00593.x","volume":"13","author":"R Francavilla","year":"2008","unstructured":"Francavilla R, Lionetti E, Castellaneta SP et al (2008) Inhibition of Helicobacter pylori infection in humans by Lactobacillus reuteri ATCC 55730 and effect on eradication therapy: a pilot study. Helicobacter 13:127\u2013134. https:\/\/doi.org\/10.1111\/j.1523-5378.2008.00593.x","journal-title":"Helicobacter"},{"key":"4186_CR53","doi-asserted-by":"publisher","DOI":"10.1002\/mbo3.70166","author":"A Azam","year":"2025","unstructured":"Azam A, Qureshi MAM, Zahoor HS et al (2025) A systematic review and meta-analysis of randomized controlled trials on the benefits of using Lactobacillus supplements as an adjunct treatment for Helicobacter pylori eradication. MicrobiolOpen. https:\/\/doi.org\/10.1002\/mbo3.70166","journal-title":"MicrobiolOpen"},{"key":"4186_CR54","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s00284-024-03994-1","volume":"82","author":"FH Haghighi","year":"2025","unstructured":"Haghighi FH, Farsiani H (2025) Is Lactococcus lactis a suitable candidate for use as a vaccine delivery system against Helicobacter pylori? Curr Microbiol 82:30. https:\/\/doi.org\/10.1007\/s00284-024-03994-1","journal-title":"Curr Microbiol"},{"key":"4186_CR55","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13100965","volume":"13","author":"L Liu","year":"2024","unstructured":"Liu L, Nahata MC (2024) Newer therapies for refractory Helicobacter pylori infection in adults: a systematic review. Antibiotics (Basel, Switzerland) 13:965. https:\/\/doi.org\/10.3390\/antibiotics13100965","journal-title":"Antibiotics (Basel, Switzerland)"}],"container-title":["European Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00228-026-04186-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00228-026-04186-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00228-026-04186-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:27:45Z","timestamp":1791275265000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00228-026-04186-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":55,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["4186"],"URL":"https:\/\/doi.org\/10.1007\/s00228-026-04186-5","relation":{},"ISSN":["0031-6970","1432-1041"],"issn-type":[{"value":"0031-6970","type":"print"},{"value":"1432-1041","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"assertion":[{"value":"24 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"258"}}