{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T14:59:07Z","timestamp":1775746747338,"version":"3.50.1"},"reference-count":62,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T00:00:00Z","timestamp":1594512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Penicillin\u2010allergic children who are infected with <jats:italic>Helicobacter pylori<\/jats:italic> constitute a relatively common subgroup. We aimed to study the short\u2010term and long\u2010term effects of bismuth quadruple therapy on gut microbiota in penicillin\u2010allergic children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively recruited treatment\u2010naive children with <jats:italic>H\u00a0pylori<\/jats:italic> infection and <jats:italic>H\u00a0pylori\u2010<\/jats:italic>negative asymptomatic children as healthy controls. Patients received 14\u2010day bismuth quadruple therapy consisting of omeprazole, clarithromycin, metronidazole, and bismuth. Fecal samples were collected at weeks 0, 2, 6, and 52. Alterations in the gut microbiota were analyzed by 16S rRNA gene sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two subjects (14 gastritis patients, 8 duodenal ulcer patients) and 23 controls participated in this study. At week 2, alpha diversity was reduced in both gastritis (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05) and ulcer (except <jats:italic>P<\/jats:italic>\u00a0=\u00a0.16 with Chao 1 index) patients compared with baseline. Some changes persisted at week 6, and all were restored at week 52. Beta diversity was significantly altered 2\u00a0weeks after treatment in the gastritis and duodenal ulcer groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002, respectively) and restored at weeks 6 and 52. The mean relative abundance of Bacteroidetes (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005, respectively) decreased and that of Proteobacteria increased (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03, respectively). All alterations recovered at week 6 and 52. In both the gastritis and ulcer groups at week 2, some beneficial bacteria were decreased including <jats:italic>Bacteroides<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003), <jats:italic>Faecalibacterium<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02), <jats:italic>Phascolarctobacterium<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004), <jats:italic>Roseburia<\/jats:italic> ( <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.13), <jats:italic>Bifidobacterium<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.08 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04), and <jats:italic>Blautia<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002). Some detrimental bacteria were increased including <jats:italic>Escherichia\u2010Shigella<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.19), <jats:italic>Klebsiella<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.09), <jats:italic>Enterococcus<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.007), and <jats:italic>Streptococcus<\/jats:italic> (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004). The changes returned to almost the pre\u2010eradication level 1\u00a0year after therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bismuth quadruple therapy causes short\u2010term dysbiosis of the gut microbiota. Most changes recovered 1\u2010year post\u2010eradication, indicating the long\u2010term safety of <jats:italic>H\u00a0pylori<\/jats:italic> therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12721","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T06:24:34Z","timestamp":1594621474000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Long\u2010term changes in the gut microbiota after 14\u2010day bismuth quadruple therapy in penicillin\u2010allergic children"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6637-5479","authenticated-orcid":false,"given":"Ying","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Children's Hospital of Fudan University  Shanghai 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