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09-05-2012 | Gastroenterology | Article

Probiotics help reduce antibiotic-associated diarrhea


Free abstract

MedWire News: Results from a systematic review and meta-analysis suggest that consumption of probiotics reduces symptoms of antibiotic-associated diarrhea (AAD).

"We found a clear beneficial effect of probiotics in preventing or treating [AAD]," said study author Sydne Newberry (RAND Health, Santa Monica, California, USA) in a press statement.

"However, more work is needed to determine which types of probiotics work best, which patients are most likely to benefit from probiotics and whether there are any risks in using them."

As many as 30% of patients prescribed antibiotics for a variety of different infections suffer from diarrhea as a result, which can result in many people stopping their medication at an early stage.

Probiotics have been suggested as a potential treatment for these side effects, but research results have been inconclusive regarding their efficacy.

To investigate further, Susanne Hempel (RAND Health) and co-researchers selected 82 randomized controlled trials for analysis. To be included, the studies had to compare probiotic use as an adjunct to antibiotics with a control consisting of no treatment, a placebo, or a different probiotic or probiotic dose. The antibiotics were taken for eradication of infections such as Helicobacter pylori.

Probiotic interventions including the genera Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus were included in the study, although most contained Lactobacillus.

A total of 63 trials with 11,811 participants were included in the meta-analysis. The team found that consuming a probiotic preparation whilst taking antibiotics reduced AAD symptoms by a significant 42% compared with no intake of probiotics.

Hempel and colleagues estimated that 13 people would need to take probiotics at the same time as antibiotics to prevent one case of associated diarrhea. They note that there was no evidence of publication bias in the analysis.

The evidence from the study was not sufficient to demonstrate the superiority of one microorganism over another or the appropriate probiotic dose for prevention of diarrhea, say the authors.

"More research is needed to determine which probiotics are associated with the greatest efficacy and for which patients receiving which specific antibiotics," they write.

"Our review found sufficient evidence to conclude that adjunct probiotic administration is associated with a reduced risk of AAD," conclude Hempel et al in JAMA.

"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."

By Helen Albert

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