Nine RCTs (n=1,343) were included in the review. Four studies had a quality score of 5, four studies had a score of 4 and one study scored 3.
Eradication rates: Using intention to treat analysis, lactoferrin supplementation had statistically significant improved eradication rates in comparison to no lactoferrin (OR 2.26, 95% CI 1.7 to 3.0, p=0.00001). There was no statistically significant heterogeneity between trials (p=0.15). Further analyses were reported.
Side effects: Based on eight studies, lactoferrin supplementation was associated with a statistically significant reduction in total side effects (OR 0.57, 95% CI 0.35 to 0.94, p=0.03). There was evidence of statistical heterogeneity between trials (p=0.06). Results for individual symptoms were also presented.
Subgroup analysis for specific antibiotics, duration of treatments and whether or not treatment was first-time or rescue showed similar results for eradication rates. Sensitivity analysis of low-quality studies and combining with probiotics did not affect the results significantly. There was no statistical evidence for publication bias.