Efficacy of adding Probiotics to standard triple therapy for Helicobacter pylori eradication in Egyptian population

Introduction Helicobacter pylori infection is a prevalent etiology of gastrointestinal illnesses, and antibiotic resistance has reduced eradication success with conventional triple therapy. Probiotics have been proposed to enhance treatment efficacy and reduce recurrence. Aim: To evaluate the efficacy of adding probiotics to standard triple therapy for H. pylori eradication in the Egyptian population. Methods: This prospective randomized controlled trial included 324 cases with confirmed H. pylori infection by stool antigen test. Patients were randomly assigned (1:1) into two groups: Group 1 received traditional triple therapy (PPI forty milligrams, amoxicillin 1,000 mg, and clarithromycin 500 milligrams twice daily for fourteen days), while Group 2 received the same regimen plus probiotics (Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis, Linex Adult®) three times daily for 14 days. Eradication was verified through a stool antigen test 6 weeks after therapy. Data were analyzed using appropriate statistical tests, with p < 0.05 deemed significant. Results: Baseline characteristics were similar among groups. The probiotic-based quadruple treatment achieved significantly greater eradication rates than triple therapy alone (ITT: 85.8% vs. 72.8%, p = 0.004; PP: 79% vs. 62.3%, p < 0.001). No significant variances were found in endoscopic findings or adverse effects. Recurrence rates at six months were significantly reduced in the probiotic group (29% vs. 39.5%, p = 0.046). Conclusion: Adding probiotics to standard triple therapy significantly improves H. pylori eradication rates and reduces recurrence without increasing adverse effects, supporting its use as an effective adjunctive regimen in Egyptian patients.