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SYSTEMATIC REVIEW article

Front. Cell. Infect. Microbiol.
Sec. Intestinal Microbiome
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1441185
This article is part of the Research Topic Beyond Traditional Antibiotics: Innovations in Biologics, Chemical Modulators, and Microbiome Manipulation View all 3 articles

Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: A meta-analysis

Provisionally accepted
Manning Li Manning Li Ying Xie Ying Xie *
  • Sheng Jing Hospital Affiliated, China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

    Helicobacter pylori (H. pylori) is highly prevalent worldwide and is closely associated with many gastric conditions. Current methods for eradicating H. pylori include triple or quadruple therapy, including antibiotics, proton pump inhibitors, and bismuth agents; however, with antibiotic abuse and increased drug resistance rates, the effectiveness of traditional methods is gradually decreasing, with many adverse effects such as abdominal pain, diarrhea, and intolerance. In recent years, there has been controversy regarding whether adding Saccharomyces boulardii (S. boulardii) to traditional therapies is beneficial for eradicating H. pylori.To evaluate the efficacy and safety of S. boulardii as an adjuvant therapy for the eradication of H. pylori.We systematically searched the PubMed and Web of Science databases from January 2002 to January 2023. The primary outcome was the H. pylori eradication rate. The secondary outcomes included total adverse effects, abdominal pain, diarrhea, bloating, constipation, nausea, vomiting, taste disorders, and other adverse reactions. We evaluated the included studies for publication bias and heterogeneity. Fixed-and random-effects models were used for studies without and with heterogeneity, respectively, to calculate the risk ratios (RRs) and conduct sensitivity and subgroup analyses.Nineteen studies comprising 5,036 cases of H. pylori infection were included in this meta-analysis. The addition of S. boulardii to traditional therapy significantly improved the H. pylori eradication rate [RR=1.11, 95% confidence interval (CI): 1.08-1.15] and reduced the incidence of total adverse effects (RR=0.49, 95% CI: 0.37-0.66), diarrhea (RR=0.36, 95% CI: 0.26-0.48), abdominal distension (RR=0.49, 95% CI: 0.33-0.72), constipation (RR=0.38, 95% CI: 0.26-0.57), and nausea (RR=0.50, 95% CI: 0.37-0.68). However, it did not reduce the occurrence of abdominal pain, vomiting, or taste disorders. CONCLUSIONS S. boulardii supplementation in traditional eradication therapy significantly improves the H. pylori eradication rate and reduces the total adverse effects and incidence of diarrhea, bloating, constipation, and nausea.

    Keywords: Saccharomyces boulardii, Helicobacter pylori, Meta-analysis, Eradication rate, adverse effects

    Received: 30 May 2024; Accepted: 15 Jan 2025.

    Copyright: © 2025 Li and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ying Xie, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, China

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