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Meta-Analysis
. 2023 Dec 15;23(1):878.
doi: 10.1186/s12879-023-08896-4.

The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials

Lian-Hua Liu #  1 , Bin Han #  2 , Jing Tao  3 , Kai Zhang  3 , Xi-Ke Wang  3 , Wen-Yu Wang  4
Affiliations
Meta-Analysis

The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials

Lian-Hua Liu et al. BMC Infect Dis. .

Abstract

Background: It is unclear whether Saccharomyces boulardii (S. boulardii) supplementation in standard triple therapy (STT) is effective in eradicating Helicobacter pylori (H. pylori) infection in children. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effect of S. boulardii supplementation on H. pylori eradication in children.

Methods: We conducted electronic searches in PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure and Wanfang database from the beginning up to September 2023. A random-effects model was employed to calculate the pooled relative risk (RR) with 95% confidence intervals (CI) through a meta-analysis.

Results: Fifteen RCTs (involving 2156 patients) were included in our meta-analysis. Results of the meta-analysis indicated that S. boulardii in combination with STT was more effective than STT alone (intention-to-treat analysis : 87.7% vs. 75.9%, RR = 1.14, 95% CI: 1.10-1.19, P < 0.00001; per-protocol analysis : 88.5% vs. 76.3%, RR = 1.15, 95% CI: 1.10-1.19, P < 0.00001). The S. boulardii supplementation group had a significantly lower incidence of total adverse events (n = 6 RCTs, 9.2% vs. 29.2%, RR = 0.32, 95% CI: 0.21-0.48, P < 0.00001), diarrhea (n = 13 RCTs, 14.7% vs. 32.4%, RR = 0.46, 95% CI: 0.37-0.56, P < 0.00001), and nausea (n = 11 RCTs, 12.7% vs. 21.3%, RR = 0.53, 95% CI: 0.40-0.72, P < 0.0001) than STT group alone. Similar results were also observed in the incidence of vomiting, constipation, abdominal pain, abdominal distention, epigastric discomfort, poor appetite and stomatitis.

Conclusions: Current evidence indicated that S. boulardii supplementing with STT could improve the eradication rate of H. pylori, and concurrently decrease the incidence of total adverse events and gastrointestinal adverse events in children.

Keywords: Helicobacter pylori; Meta-analysis; Probiotics; Randomized controlled trials; Saccharomyces boulardii; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of study selection process
Fig. 2
Fig. 2
Forest plot for the effect of S. boulardii supplementation on H. pylori eradication rate (ITT data)
Fig. 3
Fig. 3
Forest plot for the effect of S. boulardii supplementation on H. pylori eradication rate (PP data)
Fig. 4
Fig. 4
Forest plot for subgroup analysis based on the dose and duration of S. boulardii on H. pylori eradication rate
Fig. 5
Fig. 5
Forest plot for the effect of S. boulardii supplementation on total adverse events
Fig. 6
Fig. 6
Forest plot for the effect of S. boulardii supplementation on diarrhea
Fig. 7
Fig. 7
Forest plot for the effect of S. boulardii supplementation on nausea
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