Title: Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Adverse effects: A Double-Blind Placebo-Controlled Randomized Clinical
Trial
Version: 2 Date: 03 Nov 2021
Reviewer's report:
Reviewed of “Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial”
This was a single center, double-blind, randomized, placebo-controlled trial to evaluate
the efficacy of Quadruple Therapy with probiotic supplements containing S. boulardii or
Lactobacillus reuteri (DSMZ 17648 strain) on eradication rate of H. Pylori infection.
Besides, I have some concerned
Major
1. Why choice the age less than 15 year of age in the exclusion criteria#Most studies setting of
adults are 18 years old.
2. What definition of positive of Helicobacter pylori (H.pylori)#Urea breath test (UBT) ,
pathology, serum H.pylori antibody, Rapid urease test, stool H.pylori antigen, each tests has the
different sensitivity, specificity, diagnostic rate.
3. How to confirmed the H.pylori eradication status#Urea breath test (UBT) is most reliable
diagnostic tool in the most study.
4. Why the study did not evaluate the sample sizes#
5. Did the study performed Helicobacter pylori resistant survey#There were clarithromycin
in the Quadruple Therapy regimen. However, clarithromycin resistant rate were high in some
country, and it may affect H.pylori eradication rate.
6. The side effects of Quadruple Therapy were easily observated. Study subjects,  dropped,
withdrawal study had been mentioned in the previous studies. How many patients adhesion more
the 80% and complete full regimen#
Patient compliance, antibiotics resistant were the most important factors of Eradication of
Helicobacter Pylori.
Minor
1.What kinds of proton pump inhibitors choice in this study#
esomeprazole. (Nexium®) # lansoprazole (Takepron®. OD) # pantoprazole (Pantoloc®) #
rabeprazole(pariet).
2.I suggested some reviewed literatures about why S. boulardii is superior than L. reuteri, on
eradication of H. Pylori in the discussion.
Title: Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Adverse effects: A Double-Blind Placebo-Controlled Randomized Clinical
Trial
Version: 2 Date: 03 Nov 2021
Reviewer's report:
Reviewed of “Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial”
This was a single center, double-blind, randomized, placebo-controlled trial to evaluate
the efficacy of Quadruple Therapy with probiotic supplements containing S. boulardii or
Lactobacillus reuteri (DSMZ 17648 strain) on eradication rate of H. Pylori infection.
Besides, I have some concerned
Major
1. Why choice the age less than 15 year of age in the exclusion criteria#Most studies setting of
adults are 18 years old.
2. What definition of positive of Helicobacter pylori (H.pylori)#Urea breath test (UBT) ,
pathology, serum H.pylori antibody, Rapid urease test, stool H.pylori antigen, each tests has the
different sensitivity, specificity, diagnostic rate.
3. How to confirmed the H.pylori eradication status#Urea breath test (UBT) is most reliable
diagnostic tool in the most study.
4. Why the study did not evaluate the sample sizes#
5. Did the study performed Helicobacter pylori resistant survey#There were clarithromycin
in the Quadruple Therapy regimen. However, clarithromycin resistant rate were high in some
country, and it may affect H.pylori eradication rate.
6. The side effects of Quadruple Therapy were easily observated. Study subjects,  dropped,
withdrawal study had been mentioned in the previous studies. How many patients adhesion more
the 80% and complete full regimen#
Patient compliance, antibiotics resistant were the most important factors of Eradication of
Helicobacter Pylori.
Minor
1.What kinds of proton pump inhibitors choice in this study#
esomeprazole. (Nexium®) # lansoprazole (Takepron®. OD) # pantoprazole (Pantoloc®) #
rabeprazole(pariet).
2.I suggested some reviewed literatures about why S. boulardii is superior than L. reuteri, on
eradication of H. Pylori in the discussion.
Please review this paper.
user
Title: Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Adverse effects: A Double-Blind Placebo-Controlled Randomized Clinical
Trial
Version: 2 Date: 03 Nov 2021
Reviewer's report:
Reviewed of “Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or
Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori
and Treatments# Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial”
This was a single center, double-blind, randomized, placebo-controlled trial to evaluate
the efficacy of Quadruple Therapy with probiotic supplements containing S. boulardii or
Lactobacillus reuteri (DSMZ 17648 strain) on eradication rate of H. Pylori infection.
Besides, I have some concerned
Major
1. Why choice the age less than 15 year of age in the exclusion criteria#Most studies setting of
adults are 18 years old.
2. What definition of positive of Helicobacter pylori (H.pylori)#Urea breath test (UBT) ,
pathology, serum H.pylori antibody, Rapid urease test, stool H.pylori antigen, each tests has the
different sensitivity, specificity, diagnostic rate.
3. How to confirmed the H.pylori eradication status#Urea breath test (UBT) is most reliable
diagnostic tool in the most study.
4. Why the study did not evaluate the sample sizes#
5. Did the study performed Helicobacter pylori resistant survey#There were clarithromycin
in the Quadruple Therapy regimen. However, clarithromycin resistant rate were high in some
country, and it may affect H.pylori eradication rate.
6. The side effects of Quadruple Therapy were easily observated. Study subjects,  dropped,
withdrawal study had been mentioned in the previous studies. How many patients adhesion more
the 80% and complete full regimen#
Patient compliance, antibiotics resistant were the most important factors of Eradication of
Helicobacter Pylori.
Minor
1.What kinds of proton pump inhibitors choice in this study#
esomeprazole. (Nexium®) # lansoprazole (Takepron®. OD) # pantoprazole (Pantoloc®) #
rabeprazole(pariet).
2.I suggested some reviewed literatures about why S. boulardii is superior than L. reuteri, on
eradication of H. Pylori in the discussion.
assistant