{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T04:04:42Z","timestamp":1789963482872,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"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":["J of Digest Diseases"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n \n To systematically evaluate the efficacy, safety, and optimal administration parameters (dosage, treatment duration, regimen type, and publication era of the articles) of\n Saccharomyces boulardii<\/jats:italic>\n as an adjunct therapy to\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We searched PubMed, Web of Science, and EMBASE databases for randomized controlled trials (RCTs) comparing\n S.\u00a0boulardii<\/jats:italic>\n and placebo in addition to\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication that were published up to January 2026. Pooled risk ratio (RR) and the corresponding 95% confidence interval (CI), absolute risk differences (ARD), and numbers needed to treat (NNT) were calculated. Certainty of evidence was assessed using GRADE.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Nineteen RCTs were included for analysis. Adjuvant\n S. boulardii<\/jats:italic>\n significantly improved\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication in adults (\n n<\/jats:italic>\n \u2009=\u200915; RR 1.07, 95% CI 1.03\u20131.10; ARD +5.7%; NNT 18) and children (\n n<\/jats:italic>\n \u2009=\u20093; RR 1.12, 95% CI 1.03\u20131.23; ARD +9.8%; NNT 10). Eradication gain was significant with triple therapy (\n n<\/jats:italic>\n \u2009=\u200912; RR 1.08, 95% CI 1.03\u20131.14). Eradication efficacy was consistent across different dosages, treatment durations, and publication eras (\n p<\/jats:italic>\n \u2009>\u20090.05 for subgroup interactions). Furthermore,\n S. boulardii<\/jats:italic>\n significantly halved overall adverse events (\n n<\/jats:italic>\n \u2009=\u200911; 19.7% vs. 36.0%; RR 0.51, 95% CI 0.39\u20130.66; NNT 6). GRADE certainty was moderate for eradication and low for adverse events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n S. boulardii<\/jats:italic>\n modestly improves\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication\u2014particularly with triple therapy\u2014and substantially mitigates gastrointestinal adverse events. Concurrent dosing of 5\u2009\u00d7\u200910\n 9<\/jats:sup>\n \u20131\u2009\u00d7\u200910\n 10<\/jats:sup>\n \u2009CFU\/day for 10\u201314\u2009days appears to be a reasonable and pragmatic regimen.\n <\/jats:p>\n <\/jats:sec>\n \n Systematic Review Registration<\/jats:title>\n PROSPERO registration no. CRD420251271815.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1751-2980.70071","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:39:58Z","timestamp":1789961998000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Saccharomyces boulardii<\/i>\n as an Adjunct to\n Helicobacter pylori<\/i>\n Eradication Therapy: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2472-7323","authenticated-orcid":false,"given":"Hong Kai","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu Bo","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Xin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2927-2758","authenticated-orcid":false,"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1053\/j.gastro.2017.04.022","article-title":"Global Prevalence of \n Helicobacter pylori\n Infection: Systematic Review and Meta\u2010Analysis","volume":"153","author":"Hooi J. K. 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Y.","year":"2017","journal-title":"National Medical Journal of China"},{"issue":"1","key":"e_1_2_10_26_1","first-page":"S99","article-title":"The Efficacy and Safety of Adding the Probiotic Saccharomyces boulardii to Standard Triple Therapy for Eradication of \n H. pylori\n : A Randomized Controlled Trial","volume":"6","author":"Zojaji H.","year":"2013","journal-title":"Gastroenterology and hepatology from Bed to Bench"},{"issue":"1","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1651-2227.2008.00977.x","article-title":"A Randomized, Open Trial Evaluating the Effect of Saccharomyces boulardii on the Eradication Rate of \n Helicobacter pylori\n Infection in Children","volume":"98","author":"Hurduc V.","year":"2009","journal-title":"Acta Paediatrica"},{"issue":"4","key":"e_1_2_10_28_1","first-page":"845","article-title":"Curative Effect of Saccharomyces boulardii Sachets on Chronic Gastritis Caused by \n Helicobacter pylori\n Infection in Children and Its Impact on the Levels of Serum Inflammatory Factors","volume":"47","author":"Li C.","year":"2022","journal-title":"Rawal Medical Journal"},{"issue":"3","key":"e_1_2_10_29_1","first-page":"230","article-title":"Clinical Effect of Triple Therapy Combined with Saccharomyces boulardii in the Treatment of \n Helicobacter pylori\n Infection in Children","volume":"16","author":"Zhao H.\u2010M.","year":"2014","journal-title":"Chinese Journal of Contemporary Pediatrics"},{"issue":"12","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1097\/00042737-200512000-00015","article-title":"Efficacy and Safety of Saccharomyces boulardii in Prevention of Antibiotic\u2010Associated Diarrhoea due to Helicobacter pylori Eradication","volume":"17","author":"Duman D. 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Results From the European Registry on \n Helicobacter pylori\n Management (Hp\u2010EuReg)","volume":"120","author":"Casas Deza D.","year":"2025","journal-title":"American Journal of Gastroenterology"},{"issue":"9","key":"e_1_2_10_43_1","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1365-2036.2010.04457.x","article-title":"Meta\u2010Analysis: The Effects of Saccharomyces boulardii Supplementation on \n Helicobacter pylori\n Eradication Rates and Side Effects During Treatment","volume":"32","author":"Szajewska H.","year":"2010","journal-title":"Alimentary Pharmacology & Therapeutics"},{"issue":"9","key":"e_1_2_10_44_1","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.3748\/wjg.v30.i9.1213","article-title":"Treatment of \n Helicobacter pylori\n With Potassium Competitive Acid Blockers: A Systematic Review and Meta\u2010Analysis","volume":"30","author":"Kanu J. E.","year":"2024","journal-title":"World Journal of Gastroenterology"},{"issue":"11","key":"e_1_2_10_45_1","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1086\/429916","article-title":"Saccharomyces cerevisiae\n Fungemia: An Emerging Infectious Disease","volume":"40","author":"Mu\u00f1oz P.","year":"2005","journal-title":"Clinical Infectious Diseases"},{"issue":"6","key":"e_1_2_10_46_1","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s00134-002-1267-9","article-title":"Seven Cases of Fungemia With Saccharomyces boulardii in Critically Ill Patients","volume":"28","author":"Lherm T.","year":"2002","journal-title":"Intensive Care Medicine"},{"issue":"12","key":"e_1_2_10_47_1","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1111\/myc.13375","article-title":"Incidence of \n Saccharomyces cerevisiae\n Fungemia in Hospitalised Patients Administered Saccharomyces boulardii Probiotic","volume":"64","author":"Wombwell E.","year":"2021","journal-title":"Mycoses"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0001100852.76388.ef"},{"key":"e_1_2_10_49_1","unstructured":"Jauze Saccharomyces boulardii: Risk of Fungaemia https:\/\/www.npra.gov.my\/index.php\/en\/component\/content\/article\/79\u2010english\/safety\u2010alerts\u2010main\/safety\u2010alert\u20102018\/1759\u2010saccharomyces\u2010boulardii\u2010risk\u2010of\u2010fungaemia.html?Itemid=1391."}],"container-title":["Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.70071","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1751-2980.70071","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.70071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:40:05Z","timestamp":1789962005000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1751-2980.70071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,20]]},"references-count":48,"alternative-id":["10.1111\/1751-2980.70071"],"URL":"https:\/\/doi.org\/10.1111\/1751-2980.70071","archive":["Portico"],"relation":{},"ISSN":["1751-2972","1751-2980"],"issn-type":[{"value":"1751-2972","type":"print"},{"value":"1751-2980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,20]]},"assertion":[{"value":"2026-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1751-2980.70071"}}