Helicobacter pylori in the era of probiotics: a controversial application.

Sir,

Owing to the increased rate of resistance among the Helicobacter pylori strains, the efficacy of the prescribed antibiotics has reduced globally.[1] Consequently, alternative approaches can be an option to overcome this unsolved issue in clinical trials.[2] Probiotics, as a living bacterium in gastrointestinal routes, which provides health benefits has been called as a potential candidate. Recently, several studies investigated the efficacy of different probiotics in experimental and large scale levels. Recently, Dajani et al., proposed Bifidobacterium infantis as a preferable adjuvant for several therapeutic regimens used to eradicate the H. pylori infection.[3] Although probiotic therapy as an adjuvant had been reported to be an effective approach for treatment of H. pylori, the exact mechanism is not clearly elucidated yet. Moreover, the success of each of the three investigated therapeutic regimens in study by Dajani et al., need to be evaluated separately.[2] In other words, prescription of probiotic (B. infantis) in H. pylori therapeutic regimens should be compared with particular negative control group. In other words, adding a probiotic (B. infantis) should be recommended under assumption of independent factors, including various treatment regimens. Altogether, the current findings should be recommended to clinicians with caution. Meanwhile, the current data by Dajani et al., can be a good pilot, which will be encouraging for other groups in the aforementioned area to disclose further interesting findings for drawing a comprehensive conclusion.