Efficacy Of Lactobacillus Supplemented Triple Therapy For Helicobacter Infection In Children: A Meta-analysis

Objective: The adjunctive therapeutic efficacy of Lactobacillus in H.pylori infection of children remains controversial.This meta-analysis aims to investigate the efficacy of Lactobacillus supplemented triple therapy on H.pylori eradication and therapy-related side effects in children.Methods: Pubmed,Embase and Cochrane Library were searched for relevant studies from inception to June 2018.Statistical analyses were performed by using the Revman 5.3 and Stata 12.0 software.Dichotomous outcomes were presented as relative risk(RR)with 95% confidence interval(CI).Pooled eradication rates and the incidence of side effects were calculated,subgroup analyses were conducted based on dose and duration of Lactobacillus.Results: Five studies involving 484 patients were included in this study.The eradication rate in Lactobacillus group was significantly higher than that in control group(RR=1.19,95%CI 1.07-1.33),and the incidence of diarrhea in Lactobacillus group was significantly lower than that in control group(RR=0.30,95%CI 0.10-0.85).Subgroup analyses showed that eradication rates increased significantly only in high-dose group(RR=1.36,95% CI 1.15-1.60)and long-term group(RR=1.24,95% CI1.06-1.46)compared with control group,but not in low-dose group(RR=1.08,95% CI 0.86-1.35)and short-term group(RR=1.17,95% CI0.96-1.44).Conclusions: Lactobacillus,as an adjunct to triple therapy,can increase H.pylori eradication rates as well as reduce the incidence of therapy-related diarrhea in children.And a higher dose and a longer duration of supplementation may conduce to the positive impact of Lactobacillus on H.pylori eradication.