Effect of Saccharomyces boulardii on Rescue Therapy of Helicobacter pylori Infection / 胃肠病学

ABSTRACT

In recent years, the eradication rate of standard triple therapy for Helicobacter pylori (Hp) infection has been reduced to less than 80% because of many factors, such as strain variation, drug resistance and cross infection of different strains.As more and more cases with failure of initial eradication therapy, the focus of clinical practice is to explore new alternative rescue therapies.Aims: To assess the efficacy and safety of Saccharomyces boulardii combined with moxifloxacin-based triple regimen for rescue therapy of Hp infection.Methods: A total of 400 patients with chronic gastritis who had failed initial bismuth quadruple therapy were enrolled and randomly assigned into two groups 200 cases of control group and 200 cases of test group.Patients in control group received a rescue triple therapy (esomeprazole, amoxicillin and moxifloxacin) for 14 days and those in test group with the further addition of Saccharomyces boulardii sachets.Hp eradication was assessed by 13C/14C-urea breath test four weeks after treatment, and the adverse events during treatment course were observed.Results: The Hp eradication rates in control group and test group were 80.1% (121/151) and 90.4% (142/157) by per-protocol (PP) analysis, respectively, and 60.5% (121/200) and 71.0% (142/200) by intention-to-treat (ITT) analysis, respectively.The eradication rate in test group was significantly higher than that in control group by both PP and ITT analyses (P<0.05).The incidence rate of adverse events was significantly lower in test group than in control group (9.6% vs.17.9%, P<0.05).Conclusions: Saccharomyces boulardii added to moxifloxacin-based rescue triple therapy could increase the eradication rate of Hp infection with less adverse events.