Effects of probiotics or broccoli supplementation on Helicobacter pylori eradication with standard clarithromycin-based triple therapy.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 31830776 · doi:10.3904/kjim.2019.139
What was done
A randomized controlled trial evaluated 217 patients with H. pylori-positive chronic gastritis or peptic ulcer disease in Korea. Clarithromycin resistance was screened via dual-priming PCR testing for 23S rRNA mutations (A2142G and A2143G), and 34 resistant patients (17.3%) were excluded. The remaining 183 clarithromycin-sensitive patients were randomly assigned to triple therapy alone (PPI, clarithromycin, amoxicillin; Group A, n = 61), triple therapy plus Saccharomyces boulardii (Group B, n = 61), or triple therapy plus broccoli sprout extract sulforaphane (Group C, n = 61). Eradication was measured by 13C-urea breath test 4 weeks after treatment completion.
What was found
Eradication rates showed no significant differences among groups in intention-to-treat analysis (Group A: 85.2%, Group B: 89.6%, Group C: 81.6%) or per-protocol analysis (Group A: 89.2%, Group B: 86.8%, Group C: 96.3%). Overall adverse event rates did not differ between triple therapy alone and triple therapy plus probiotics (p = 0.574) or sulforaphane (p = 1.000).
Why it matters
Adding S. boulardii or sulforaphane to standard triple therapy does not appear to improve eradication success or reduce adverse events in patients with clarithromycin-sensitive H. pylori.
Limits
Patients with clarithromycin-resistant strains were excluded, so findings cannot be generalized to antibiotic-resistant infections. The abstract does not specify blinding procedures, exact supplement dosages, treatment durations, or specific types of adverse events.
Cited by
- contradicts Sulforaphane exerts protective antimicrobial effects against Helicobacter pylori and small intestinal bacterial overgrowth (SIBO).