Probiotics associated with reduced risk of diarrhea from antibiotic use: study

May 8, 2012, JAMA and Archives Journals

Consumption of probiotics (live microorganisms, which may occur naturally in foods such as yogurt, intended to confer a health benefit when consumed) is associated with a reduced risk of antibiotic-associated diarrhea, a common adverse effect of antibiotic use, according to a review and meta-analysis of previous studies published in the May 9 issue of JAMA.

"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 ," according to background information in the article. Potentially, probiotics maintain or restore gut microecology () during or after antibiotic treatment. "There is an increasing interest in probiotic interventions, and evidence for the effectiveness of probiotics in preventing or treating AAD is also increasing," the authors write.

Susanne Hempel, Ph.D., of RAND Health, Santa Monica, Calif., and colleagues conducted a study to evaluate the available evidence on probiotic use for the prevention or treatment of AAD. Reviewers searched databases to identify (RCTs) involving AAD and probiotics (, Bifidobacterium, Saccharomyces, Streptococcus, , and/or Bacillus). A total of 82 RCTs met inclusion criteria.

The majority of the RCTs used Lactobacillus-based interventions alone or in combination with other genera (a subdivision of a family of organisms); strains were poorly documented. Of all included trials, 63 reported the number of participants with diarrhea and the number of participants randomized to both treatment groups. Across 63 RCTs (n = 11,811 participants), probiotic use was associated with a 42 percent lower risk of developing diarrhea compared with a control group not using probiotics. The result was consistent across a number of subgroup and sensitivity analyses. The treatment effect equates to a number needed to treat of 13.

The researchers note that there exists significant heterogeneity (differences across studies) in pooled results and the evidence is insufficient to determine whether this association varies systematically by population, antibiotic characteristic, or probiotic preparation.

"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," the authors conclude.

Explore further: Probiotics effective in combating antibiotic-associated diarrhea

More information: JAMA. 2012;307[18]:1959-1969.

Related Stories

Probiotics effective in combating antibiotic-associated diarrhea

October 31, 2011
In four different studies presented at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC, researchers explored the effectiveness of probiotics for antibiotic-associated diarrhea; ...

Could a probiotic be used to treat inflammatory bowel disease?

October 20, 2011
Scientists have been unclear for some time about how most probiotics work. A new study has found a scientific 'design' for a probiotic that could be used to treat inflammatory bowel disease (IBD), such as Crohn's disease.

Recommended for you

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

Price tag on gene therapy for rare form of blindness: $850K

January 3, 2018
A first-of-its kind genetic treatment for blindness will cost $850,000 per patient, making it one of the most expensive medicines in the world and raising questions about the affordability of a coming wave of similar gene-targeting ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.