TOPLINE: 

Addition of Saccharomyces boulardii CNCM I-745 (Sb), a probiotic, to Helicobacter pylori eradication therapy was associated with improved eradication rates — particularly when combined with a concomitant regimen containing clarithromycin, amoxicillin, and metronidazole or tinidazole — and a lower incidence of adverse events.

METHODOLOGY:

• Researchers analysed data from the European Registry on H pylori Management (Hp-EuReg) to assess the effectiveness and safety of Sb as an adjunct for H pylori eradication (May 2013-December 2023).
• They used a modified intention-to-treat analysis to assess effectiveness and included 41,298 treatments. Treatments were categorised by probiotic use into those including Sb as a single‑strain adjunct (n = 2890) and those without a probiotic (n = 38,408).
• Safety was evaluated based on the incidence of at least one adverse event during eradication therapy.

TAKEAWAY:

• Among patients receiving a regimen containing clarithromycin, amoxicillin, and metronidazole or tinidazole, adjunctive Sb was associated with improved H pylori eradication rates compared with no probiotic (93% vs 90%; adjusted odds ratio [aOR], 2.32; P < .05).
• Use of Sb was independently associated with a lower risk of experiencing any adverse event (aOR, 0.80; P < .05).
• Compared with nonusers, Sb users experienced lower rates of diarrhoea (7.5% vs 5.0%), dysgeusia (7.0% vs 5.0%), nausea (7.0% vs 4.0%), dyspepsia (3.0% vs 2.5%), abdominal pain (4.0% vs 2.0%), asthenia (4.0% vs 2.0%), heartburn (2.0% vs 1.0%), and anorexia (3.0% vs 0.3%).

IN PRACTICE:

"These real-world findings support the incorporation of Sb into H pylori eradication strategies, reinforcing the value of probiotics in improving tolerability and potentially effectiveness in selected clinical settings," the authors of the study wrote. 

SOURCE:

This study was led by Olga P. Nyssen, Hospital Universitario de La Princesa, Madrid, Spain. It was published online on April 1, 2026, in Helicobacter.

LIMITATIONS:

The study was limited by its observational nonrandomized design, its reliance on self‑reported compliance, and the relatively small Sb‑treated cohorts, which precluded reliable evaluation of trends over time.

DISCLOSURES:

This study was promoted and funded by the European Helicobacter and Microbiota Study Group. The Hp-EuReg was co-funded by the European Union programme HORIZON and supported by UK Research and Innovation. Two authors reported receiving research funding or serving as speakers, consultants, or advisory mem­bers for various pharmaceutical and diagnostic companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.