Effectiveness and safety of probiotics combined with bismuth-containing quadruple therapy for eradication of Helicobacter pylori: a meta-analysis

Objective To systematically evaluate the effectiveness and safety of probiotics combined with bismuth-containing quadruple therapy for eradication of Helicobacter pylori. Methods The databases including PubMed, SCIE, EMbase, Biosis Previews, ELSEVIER, Science Direct, Springer Link, the Cochrane Library, CBM, VIP, WanFang Data and CNKI were searched to collect randomized controlled trials (RCT) before July 2016. Data extraction and quality assessment were performed by 2 independent reviewers. Meta analyses were conducted using RevMan 5.3 software. Results A total of 11 studies involving 1 589 participants were included. According to intention-to-treat (ITT) analysis, H.pylori eradication rate in experimental group was 90.5% and 82.1% in control group with signifcant difference (OR=2.13, 95%CI:1.58-2.88, P< 0.001). The incidences of adverse reaction in experimental group was 13.9% and 27.5% in control group with signifcant difference (OR=0.42, 95%CI:0.30-0.59, P< 0.001). Conclusion Current evidence indicates that probiotics combined with bismuth-containing quadruple therapy can improve eradication rate of Helicobacter pylori and reduce the incidences of adverse reaction.