Optimization of eradication treatment for chronic gastroduodenitis associated with Helicobacter pylori in children using spore recombinant probiotic based on Bacillus subtilis
Background. The relevance is associated with a significant spread of Helicobacter pylori (Hp) in children in Ukraine. Chronic gastroduodenitis is the main nosology in children associated with Hp, which requires comprehensive treatment, first of all eradication one. To optimize the effective use of eradication schemes, current international recommendations provide for the possibility of prescribing probiotics. The purpose of the study was to evaluate the influence of Subalin probiotic on eradication efficacy and tolerability of anti-Helicobacter therapy in children aged 12–18 years with Hp-positive chronic gastroduodenitis. Materials and methods. Design: a single-center open comparative study. The study included 50 children with Hp-associated chronic gastroduodenitis aged 12 to 18 years. Patients are divided into 2 groups depending on the probiotic administration. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp infection. The results were recorded in a specially developed individual patient’s chart and statistically processed. Results. The results of using Subalin probiotic in patients of the main group concomitantly with the standard first-line pediatric schemes of Hp eradication in children and adolescents with Hp-positive forms of chronic gastroduodenitis indicate the advisability, effectiveness and prospects of such treatment. This is confirmed by the positive dynamics of complaints, the absence of side effects (including antibiotic-associated diarrhea), and good tolerability of drugs in triple or quadruple therapy regimens against the background of receiving spore recombinant probiotic in the vast majority of patients. Patients from the comparison group also had a positive dynamics in the main complaints, but less pronounced. However, the worsening of tolerability and side effects from standard eradication schemes were significantly more frequent (on average 35–40 %) compared with main group. In addition, administration of Subalin increases by 5 % the efficiency of eradication of standard first-line anti-Hp regimens. Conclusions. The use of spore recombinant probiotic Subalin together with standard eradication schemes in children from 12 years of age is advisable, since it allows increasing the eradication efficiency by 5 %, improving the tolerability of anti-Hp drugs and, accordingly, the adherence of patients to the treatment and recommendations. The possibility of using Bacillus subtilis already at the first stage of treatment helps to optimize therapeutic measures in older children with Hp-positive variants of chronic gastroduodenitis.
Full Text:PDF (Українська)
Belousova OYu. Once again, the risk factors for the development of upper digestive tract pathology and the optimization of eradication therapy in pediatric practice. Zdorov’ja Ukrai'ny - Special issue Pediatrics. 2016;(38):24-26. (in Russian).
Fadeenko HD, Belousova OYu, Pavlenko NV. Age features of the course of gastrointestinal diseases associated with Helicobacter pylori and their rational correction: guidance. Kyiv: 2015. 32 p.
Belousova OYu, Pavlenko NV, Voloshin KV, Savytska KV, Slobodianiuk OL. Modern problems of treatment of Helicobacter-associated diseases in children: opportunities of adjuvant therapy. Zdorovʹe rebenka. 2017;12:(2.1)41-50. doi: 10.22141/2224-05188.8.131.52.2017.100987.
Koletzko S, Jones NL, Goodman KJ, et al. Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr. 2011 Aug;53(2):230-43. doi: 10.1097/MPG.0b013e3182227e90.
Shadrin OG, Zaytceva NE, Garicheva TA. Helicobacter pylori in children: modern approaches to diagnosis and ways to optimize therapy. Sovremennaya pediatriya. 2014;5(61):119-127. doi: 10.15574/SP.2014.61.119PEDIATRIYA. 2014. 5(61):119-127. (in Russian).
Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection – the Maastricht IV/ Florence Consensus Report. Gut. 2012 May;61(5):646-64. doi: 10.1136/gutjnl-2012-302084.
Ministry of Health of Ukraine. Order No 59, dated 29 Jan, 2013: On approval of unified clinical protocols of medical care for children with diseases of the digestive system. Available from: http://old.moz.gov.ua/ua/portal/dn_20130129_0059.html.
Goel A, Aggarwal R. Probiotics as adjunctive therapy for eradication of Helicobacter pylori infection (Protocols). Cochrane Database of Systematic Reviews. 2013. Issue 10. Art. No.: CD010776. doi: 10.1002/14651858.CD010776.
Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506-14. doi: 10.1038/nrgastro.2014.66.
Hauser G, Salkic N, Vukelic K, JajacKnez A, Stimac D. Probiotics for standard triple Helicobacter pylori eradication: a randomized, double-blind, placebo-controlled trial. Medicine (Baltimore). 2015 May;94(17):e685. doi: 10.1097/MD.0000000000000685.
Floch MH, Walker WA, Sanders ME, et al. Recommendations for probiotic use — 2015 update: proceedings and consensus opinion. J Clin Gastroenterol. 2015 Nov-Dec;49 Suppl 1:S69-73. doi: 10.1097/MCG.0000000000000420.
Du Y-Q, Su T, Fan J-G, et al. Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection. World J Gastroenterol. 2012 Nov 21;18(43):6302-7. doi: 10.3748/wjg.v18.i43.6302.
Tong JL, Ran ZH, Shen J, Zhang CX, Xiao SD. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2007 Jan 15;25(2):155–68. doi: 10.1111/j.1365-2036.2006.03179.x.
Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10.1002/14651858.CD004827.pub4.
Quigley EM. Therapies aimed at the gut microbiota and inflammation: antibiotics, prebiotics, probiotics, synbiotics, anti-inflammatory therapies. Gastroenterol Clin North Am. 2011 Mar;40(1):207-22. doi: 10.1016/j.gtc.2010.12.009.
Lee SW, Park HJ, Park SH, Kim N, Hong S. Immunomodulatory effect of poly-c-glutamic acid derived from Bacillus subtilis on natural killer dendritic cells. Biochem Biophys Res Commun. 2014 Jan 10;443(2):413-21. doi: 10.1016/j.bbrc.2013.11.097.
Ceragioli M, Cangiano G, Esin S, Ghelardi E, Ricca E, Senesi S. Phagocytosis, germination and killing of Bacillus subtilis spores presenting heterologous antigens in human macrophages. Microbiology. 2009 Feb;155(Pt 2):338-46. doi: 10.1099/mic.0.022939-0.
Prazdnova EV, Chistyakov VA, Churilov MN, et al. DNA-protection and antioxidant properties of fermentates from Bacillus amyloliquefaciens B-1895 and Bacillus subtilis KATMIRA1933. Lett Appl Microbiol. 2015 Dec;61(6):549-54. doi: 10.1111/lam.12491.
Lefevre M, Racedo SM, Ripert G. Probiotic strain Bacillus subtilis CU1 stimulates immune system of elderly during common infectious disease period: a randomized, double-blind placebo-controlled study. Immun Ageing. 2015 Dec 3;12:24. doi: 10.1186/s12979-015-0051-y. eCollection 2015.
Copyright (c) 2018 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020