{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:52:35Z","timestamp":1791402755982,"version":"4.3.3"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Gastroenterol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> eradication is recommended as a way of providing symptomatic relief for dyspepsia. The limited efficacy of triple therapy is a major problem in many countries, including Thailand. Some probiotics have been shown to improve the <jats:italic>H. pylori<\/jats:italic> eradication rate and reduce side effects. This study aimed at evaluating the efficacy of probiotic (Lacidofil<jats:sup>\u00ae<\/jats:sup> STRONG) as adjuvant to standard triple therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, double-blind, placebo-controlled study was conducted between July 2020 and June 2022. Eligible patients with <jats:italic>H. pylori<\/jats:italic> gastritis (i.e., <jats:italic>n<\/jats:italic>=90 out of the 160 patients screened) were randomized to receive 14-day standard triple therapy either with probiotics or with a placebo (N=45\/group). The treatment regimen entailed 30\u00a0mg lansoprazole administered twice daily, 1,000\u00a0mg amoxicillin administered twice daily, and 1\u00a0g clarithromycin modified-release formulation administered once daily. A probiotic capsule containing <jats:italic>Lacticaseibacillus rhamnosus<\/jats:italic> R0011 <jats:italic>and Lactobacillus helveticus<\/jats:italic> R0052 (Lacidofil<jats:sup>\u00ae<\/jats:sup> STRONG) or placebo were given twice daily during the eradication therapy and for an additional 4 weeks. Successful <jats:italic>H. pylori<\/jats:italic> eradication was defined as a negative <jats:sup>13<\/jats:sup>C-urea breath test at least 4 weeks after complete eradication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As per-protocol analysis, eradication rates after the 14-day regimen with probiotic or placebo were 90.9% and 75.0% (<jats:italic>p<\/jats:italic>=0.047), respectively. Antibiotic susceptibility testing demonstrated high clarithromycin resistance (24%). For clarithromycin-resistant strains, there was no statistical difference in eradication rates between the probiotic and placebo groups. Furthermore, probiotic supplementation significantly reduced treatment side effects, including bloating (OR 0.27 [95% CI 0.10 to 0.75], <jats:italic>p<\/jats:italic>=0.012), diarrhea (OR 0.23 [95% CI 0.28 to 0.65], <jats:italic>p<\/jats:italic>=0.006), nausea (OR 0.05 [95% CI 0.01 to 0.36], <jats:italic>p<\/jats:italic>=0.003), and bitter taste (OR 0.14 [95% CI 0.03 to 0.69], <jats:italic>p<\/jats:italic>=0.015). In addition, the probiotic group had lower gastrointestinal symptom rating scale (GSRS) scores (1.46\u00a0\u00b1\u00a00.36 vs. 2.65\u00a0\u00b1\u00a00.66, <jats:italic>p<\/jats:italic>&amp;lt;0.001) and higher SF-36 health-related quality-of-life scores (63.3 \u00b1 10.2 vs. 57.3 \u00b1 13.4, <jats:italic>p<\/jats:italic>=0.020) after treatment than the placebo group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The probiotic adjuvant with 14-day standard triple therapy improved the <jats:italic>H. pylori<\/jats:italic> eradication rate. Supplementation with Lacidofil<jats:sup>\u00ae<\/jats:sup> STRONG during the 2-week eradication treatment and 4-week follow-up phase can help to reduce the gastrointestinal side effects of eradication therapy and increase patients\u2019 general health-related quality of life.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fgstr.2023.1245993","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T03:11:51Z","timestamp":1694747511000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["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"],"prefix":"10.3389","volume":"2","author":[{"given":"Anya","family":"Kiattiweerasak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuda","family":"Aumpan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soonthorn","family":"Chonprasertsuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bubpha","family":"Pornthisarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sith","family":"Siramolpiwat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patommatat","family":"Bhanthumkomol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongjarat","family":"Nunanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navapan","family":"Issariyakulkarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varocha","family":"Mahachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratha-korn","family":"Vilaichone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327745","article-title":"Management of Helicobacter pylori infection: the Maastricht VI\/Florence consensus report","volume":"71","author":"Malfertheiner","year":"2022","journal-title":"Gut"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-320839","article-title":"Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis","volume":"69","author":"Ford","year":"2020","journal-title":"Gut"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.022","article-title":"Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis","volume":"153","author":"Hooi","year":"2017","journal-title":"Gastroenterology"},{"key":"B4","unstructured":"FerlayJ\n            ErvikM\n            LamF\n            ColombetM\n            MeryL\n            Pi\u00f1erosM\n          Lyon, FranceInternational agency for research on cancerGlobal cancer observatory: cancer today"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7314\/APJCP.2016.17.5.2351","article-title":"Thailand consensus on Helicobacter pylori treatment 2015","volume":"17","author":"Mahachai","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document. 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