Abstract
Over the past decade, the growth of Helicobacter pylori antibiotic resistance has had an increasingly significant impact on the choice of eradication therapy regimens, significantly limiting the number of effective treatment options. The Maastricht VI guidelines consider the use of probiotics as one way to optimise therapy and increase the likelihood of successful eradication. In this regard, the study of the possible mechanisms of action of probiotic preparations on antibiotic-resistant strains of H. pylori, as well as their possible role in preventing the development of resistance, is of considerable interest and may contribute to improving the quality of eradication therapy in the near future. The aim of the study is to determine the role of probiotics in modifying the microbiota during and after eradication therapy, as well as to assess their potential impact on the development of antibiotic resistance. A search for scientific publications was conducted in international and national bibliographic databases: PubMed, Embase, Scopus, Web of Science Core Collection, Google Scholar, and eLIBRARY.ru. The search was conducted in English, Russian, and Kazakh for the period from 26 April 2015 to 14 July 2025. The review includes 41 publications. Eradication therapy has a pronounced negative effect on the intestinal microbiota, leading to disruption of its composition and the development of side effects that reduce treatment tolerability. A number of studies in recent years have demonstrated a link between antibiotic therapy and the development of antibiotic resistance caused by genetic rearrangements and mutations in the gut microbiota genome. As an additional approach to correcting these adverse effects, special attention is paid to the use of probiotics. According to the research results, probiotic preparations help reduce the frequency of side effects of eradication therapy and may increase its effectiveness against antibiotic-resistant strains of H. pylori. The use of probiotic preparations in the treatment of resistant strains of Helicobacter pylori is a promising direction that opens up new opportunities for optimising eradication regimens. However, this approach requires further clinical and experimental studies to confirm its effectiveness and form reasonable prognostic conclusions.