Probiotics help prevent antibiotic-associated diarrhea

May 8, 2012 in Nutrition Topics in the News

Probiotics help prevent antibiotic-associated diarrhea

Taking probiotics on top of a course of antibiotics may help ward off the diarrhea that often comes along with antibiotic treatment, a new review of past studies suggests.

When researchers combined trials of all types of the gut-healthy microbes, they found that patients with a range of conditions -- from ear infections to sepsis -- were 42 percent less likely to get diarrhea from their antibiotic drugs if they were also taking a probiotic.

One-quarter to one-third of people treated with an antibiotic typically get diarrhea as a result, researchers said. It's often not more than an unpleasant side effect, but can be serious enough to send some patients to the hospital.

Probiotics refer to live organisms (e.g. bacteria and yeast) that, when consumed in certain amounts, exert health benefits.  They're normally found in your digestive tract as part of the intestinal flora, a community of more than 400 species of bacteria.  Here, probiotic bacteria help inhibit the growth of unfriendly, disease-causing bacteria and stimulate the body's immune response.

It's thought that probiotics prevent antibiotic-associated diarrhea by restoring the balance of friendly bacteria in the intestinal tract. Antibiotics kill both the good and bad bacteria in the gut.

The research team reviewed 63 trials in which researchers had randomly assigned a total of almost 12,000 patients needing antibiotic treatment to probiotics or a placebo pill or nothing.

The researchers couldn't tell from their analysis whether one type of probiotic in particular was any better than others, especially since most of the studies used a combination of multiple bacterial strains. The most common probiotics used were from the genus Lactobacillus.

Not being able to differentiate the benefits of different strains is a limitation, according to some researchers -- because as with antibiotics, each strain of probiotic can have very different effects.

The researchers said they don't really know which specific strains are the best to recommend. And they are clear on what dose is required or for how long we should give it. The studies included in the analysis gave probiotics for anywhere from one day to two weeks.

Most of the studies included in the analysis were small and didn't report on side effects from the probiotics. But those that did concluded the supplements seemed safe.

"It's a relatively safe intervention (and) it's a relatively harmless intervention, so if you know you're prone to antibiotic-associated diarrhea, and if it's an antibiotic that's prone to cause antibiotic-associated diarrhea, that's when I think of using it," the researchers said.

For small babies or very sick patients, however, researchers warned probiotics could be harmful.

There's some evidence that probiotics may have a beneficial effect as an add-on therapy in patients with recurrent Clostridium difficile, a diarrhea-causing infection that can occur after antibiotic treatment wipes out normal gut flora.

SOURCE: Journal of the American Medical Association, May 8, 2012.

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