The authors wrote, as background information:
"The use of antibiotics that disturb the gastrointestinal flora [microbes] is associated with clinical symptoms such as diarrhea, which occurs in as many as 30 percent of patients. Symptoms range from mild and self-limiting to severe, particularly in Clostridium difficile infections, and antibiotic-associated diarrhea (AAD) is an important reason for nonadherence with antibiotic treatment."
Probiotics can restore or maintain gut microeconlogy, either during or after taking antibiotics.
The researchers added:
"There is an increasing interest in probiotic interventions, and evidence for the effectiveness of probiotics in preventing or treating AAD is also increasing."
Susanne Hempel, Ph.D. and team set out to determine how effective probiotic usage might be in the treatment or prevention of AAD (antibiotic-associated diarrhea). They gathered information on various databases to identify RCTs (randomized controlled trials) involving AAD and probiotics, specifically Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus. They eventually identified 82 trials.
Most of the trials used interventions with Lactobacillus on its own, or together with other genera. Of all the RCTs they examined, 63 gave data on how many participants had diarrhea and how many had been randomized to both treatment groups. Out of a total of 11,811 participants, they found that there was a 42% lower risk of developing diarrhea among those on probiotics compared to those who were not.
The authors added that their results were consistent across several subgroup and sensitivity analyses. They also noted there there are still considerable differences across studies in pooled results; there is not enough evidence to determine whether this association differs according to population, types of probiotics, and the type of antibiotic prescribed.
Probiotic preparations are becoming increasingly popular worldwide
The authors concluded:
"In summary, our review found sufficient evidence to conclude that adjunct probiotic administration is associated with a reduced risk of AAD. This generalized conclusion likely obscures heterogeneity in effectiveness among the patients, the antibiotics, and the probiotic strains or blends. Future studies should assess these factors and explicitly assess the possibility of adverse events to better refine our understanding of the use of probiotics to prevent AAD."
Written by Christian Nordqvist