Use of probiotics in the Helicobacter pylori eradication in Italy: data from the Italian Registry on Helicobacter pylori treatment

Background: Probiotics may have beneficial effect in reducing ad-verse events in patients treated for Helicobacter (H.) pylori infection; however, data on their use in this setting are scarce. Aim: To investigate the use of probiotic supplementation in the treatment of H. pylori infection in clinical practice in Italy. Methods: The “Italian Registry on H. pylori treatment” is an online database prospectively registering adult patients prescribed with a treatment for H. pylori infection by gastroenterologists in Italy. Data were collected in 17 Centers from June 2017 to May 2019 using the web application REDCap (Research Electronic Data Capture). Results: A total of 1803 patients [1140 (63.5%) females, mean age (SD): 55.4 years (15.1)] were included in the Registry in the study period. Of these, 1699 received one treatment regimen, 101 two regimens and 3 three regimens, with a total of 1910 cases. Probiotics were prescribed in 49.9% (n. 953) of cases: 100% (61/61) with ri-fabutin triple therapy, 86.4% (472/546) with sequential therapy, 54.2% (77/142) with levofloxacin triple therapy, 46.3% (38/82) with concomitant therapy, 33% (211/641) with bismuth quadruple therapy (Pylera®), 24.1% (90/374) with clarithromycin triple therapy and 21.1% (4/19) with other regimens. The most frequently pre-scribed probiotic was a combination of Lactobacillus rhamnosus and Bifidobacterium breve (586, 61.5%), followed by Lactobacillus casei DG(118, 12.4%), Lactobacillus rhamnosus (85, 8.9%), Saccaromyces boulardii (74, 7.8%) and others probiotics (90, 9.4%). Conclusions: Probiotic supplementation is used in half of patients treated for H. pylori eradication in Italy. Lactobacillus and Bifidobacterium are the probiotics most commonly prescribed