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Probiotic Yogurt May Help Eradicate H. pylori Infection

  • Authors: News Author: Laurie Barclay, MD
    CME Author:
    Désirée Lie, MD, MSEd
  • CME Released: 4/17/2006
  • Valid for credit through: 4/17/2007
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Target Audience and Goal Statement

This article is intended for primary care clinicians, gastroenterologists, and other specialists who care for patients with H. pylori infection.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • Describe the effect of pretreatment with AB-yogurt before quadruple therapy on H. pylori eradication in patients with failed H. pylori eradication on triple therapy.
  • Describe the effect on delta 13CO2/mL values of the urea breath test by adding yogurt to quadruple therapy for H. pylori infection



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  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.


    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.


  • Gary Vogin, MD

    Senior Medical Editor, Medscape


    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

CME Author(s)

  • Désirée Lie, M.D., M.S.Ed.

    Clinical Professor of Family Medicine; Director, Division of Faculty Development, University of California, Irvine School of Medicine, Irvine, California


    Desiree Lie, MD, MSEd, has disclosed no relevant financial relationships.

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Probiotic Yogurt May Help Eradicate H. pylori Infection

Authors: News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures

CME Released: 4/17/2006

Valid for credit through: 4/17/2007


April 17, 2006 — Probiotic yogurt enhances the effectiveness of quadruple therapy for eradicating residual Helicobacter pylori infection, according to the results of a randomized study reported in the April issue of the American Journal of Clinical Nutrition.

"Lactobacillus- and Bifidobacterium-containing yogurt (AB-yogurt) can suppress Helicobacter pylori," write Bor-Shyang Sheu, MD, from the National Cheng Kung University in Tainan, Taiwan, and colleagues. "Improvement of the eradication rate by quadruple therapy of residual H. pylori after failed triple therapy is needed."

To assess antimicrobial resistance, 138 patients in whom triple therapy failed were enrolled for a culture study of H. pylori and randomized to either a yogurt-plus-quadruple therapy group or a quadruple therapy–only group. Patients received 1 week of quadruple therapy with or without 4 weeks of pretreatment with AB-yogurt, 400 mL/day.

Before and every 2 weeks during the 4-week period of yogurt ingestion, excessive delta 13CO2/mL values of the 13C-urea breath test were collected in the yogurt-plus-quadruple therapy group. Both groups had a 13C-urea breath test at least 6 weeks after the quadruple therapy to evaluate the outcome of residual H. pylori eradication.

After the 4-week ingestion period of AB-yogurt, the patients in the yogurt-plus-quadruple therapy group infected with either antibiotic-sensitive or antibiotic-resistant H. pylori had significant decreases in excessive delta 13CO2/mL values of the 13C-urea breath test (P < .0001). Compared with the quadruple therapy–only group, the yogurt-plus-quadruple therapy group had a higher H. pylori eradication rate (intent-to-treat analysis, 85% vs 71.1%; P < .05; per-protocol analysis, 90.8% vs 76.6%; P < .05).

"A 4-week pretreatment with AB-yogurt can decrease H. pylori loads despite antimicrobial resistance, thus improving the efficacy of quadruple therapy in eradicating residual H. pylori," the authors write. "It is of scientific interest to know whether the yogurt or the probiotic was more effective in increasing the success rate. Because yogurt is part of daily food consumption, it would be interesting to know whether yogurt types with or without different probiotic isolates exert different effects."

The authors have disclosed no relevant financial relationships.

Am J Clin Nutr. 2006;83:864-869