Probiotics reduce risk of diarrhea from antibiotic use

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.

"The use of antibiotics that disturb the gastrointestinal flora,  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," 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.

Scientifics conducted a study to evaluate the available evidence on probiotic use for the prevention or treatment of AAD. Reviewers searched databases to identify randomized controlled trials (RCTs) involving AAD and probiotics (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus). A total of 82 RCTs met inclusion criteria.

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