Probiotics for Antibiotic-induced Diarrhea

Please note that each Antibiotic-induced diarrhea probiotics trial is not described in detail. In some trials, drugs, prebiotics and/or additional nutrients were provided that may help the beneficial bacteria be more effective. Also the setting, procedure, and dose for each trial are rarely similar. For more details, search for the reference in Google to find the original publication. The simplest way is to copy and paste the title.

Antibiotic-induced diarrhea is often a consequence of those taking strong antibiotics. It is a particular problem for those being treated for Helicobacter pylori infections (the bacteria that is associated with stomach ulcers). Studies suggest that probiotic can help. In most clinical trials, the probiotics are given daily and started either one week before the start of the antibiotics or at the same time. Probiotics are usually continued throughout antibiotic treatment and stopped a week after the antibiotics are completed. Comparisons are made to groups that receive only a standard treatment.

Probiotic SupplementsImprovements Seen in TrialReferences
FlorajenImprovement1
LacidofilSome improvement2
YoghurtNo improvement3
Multi-species probioticImprovement4
Bifidobacterium
Lactobacilli
Improvement5
Yoghurt bacteria
B. lactis BB-12
L. acidophilus LA-5
L. rhamnosus GG
Improvement6
L. bulgaricus
L. casei
S. thermophilus
Improvement7
L. rhamnosus E/N
L. rhamnosus Oxy
L. rhamnosus Pen
Improvement8
B. lactis
S. thermophilus
Improvement9
B. bifidum
L. acidophilus
Protects bacterial composition10
L. acidophilus CL1285
L. casei LBC80R
Improvement11
B. lactis BB-12
L. acidophilus LA-5
Improvement12
B. clausiiImprovement13
L. plantarumSome improvement14
L. reuteriImprovement15
L. reuteri ATCC 55730Improvement16
L. rhamnosus GGImprovement5, 17-19
S. boulardiiImprovement5, 20

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

References

1.         Safdar, N. B., R.; Said, A.; McKinley, L. 2008. Feasibility and tolerability of probiotics for prevention of antibiotic-associated diarrhoea in hospitalized US military veterans. J Clin Pharm Ther 33:663-668.

2.         Song, H. J. K., J. Y.; Jung, S. A.; Kim, S. E.; Park, H. S.; Jeong, Y.; Hong, S. P.; Cheon, J. H.; Kim, W. H.; Kim, H. J.; Ye, B. D.; Yang, S. K.; Kim, S. W.; Shin, S. J.; Kim, H. S.; Sung, J. K.; Kim, E. Y. 2010. Effect of probiotic Lactobacillus (Lacidofil(R) cap) for the prevention of antibiotic-associated diarrhea: a prospective, randomized, double-blind, multicenter study. J Korean Med Sci 25:1784-1791.

3.         Conway, S. H., A.; Clark, A.; Harvey, I. 2007. Does eating yogurt prevent antibiotic-associated diarrhoea? A placebo-controlled randomised controlled trial in general practice. Br J Gen Pract 57:953-959.

4.         Koning, C. J. J., D. M.; Stobberingh, E. E.; Mulder, L.; Rombouts, F. M.; Stockbrugger, R. W. 2008. The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin. Am J Gastroenterol 103:178-189.

5.         Cremonini, F. D. C., S.; Covino, M.; Armuzzi, A.; Gabrielli, M.; Santarelli, L.; Nista, E. C.; Cammarota, G.; Gasbarrini, G.; Gasbarrini, A. 2002. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 97:2744-2749.

6.         Wenus, C. G., R.; Loken, E. B.; Biong, A. S.; Halvorsen, D. S.; Florholmen, J. 2008. Prevention of antibiotic-associated diarrhoea by a fermented probiotic milk drink. Eur J Clin Nutr 62:299-301.

7.         Hickson, M. D. S., A. L.; Muthu, N.; Rogers, T. R.; Want, S.; Rajkumar, C.; Bulpitt, C. J. 2007. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ 335:80.

8.         Ruszczynski, M. R., A.; Szajewska, H. 2008. Clinical trial: effectiveness of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) in the prevention of antibiotic-associated diarrhoea in children. Aliment Pharmacol Ther 28:154-161.

9.         Correa, N. B. P. F., L. A.; Penna, F. J.; Lima, F. M.; Nicoli, J. R. 2005. A randomized formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic-associated diarrhea in infants. J Clin Gastroenterol 39:385-389.

10.       Madden, J. A. P., S. F.; Tang, J.; Garaiova, I.; Plummer, N. T.; Herbison, M.; Hunter, J. O.; Shimada, T.; Cheng, L.; Shirakawa, T. 2005. Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: a double-blind, placebo-controlled pilot study. Int Immunopharmacol 5:1091-1097.

11.       Gao, X. W. M., M.; Fang, C. Y.; Reifer, C.; Miller, L. E. 2010. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients. Am J Gastroenterol 105:1636-1641.

12.       de Vrese, M. K., H.; Rautenberg, P.; Laue, C.; Schrezenmeir, J. 2011. Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J Dairy Res 78:396-403.

13.       Nista, E. C. C., M.; Cremonini, F.; Cazzato, I. A.; Zocco, M. A.; Franceschi, F.; Cammarota, G.; Gasbarrini, G.; Gasbarrini, A. 2004. Bacillus clausii therapy to reduce side-effects of anti-Helicobacter pylori treatment: randomized, double-blind, placebo controlled trial. Aliment Pharmacol Ther 20:1181-1188.

14.       Lonnermark, E. F., V.; Lappas, G.; Sandberg, T.; Berggren, A.; Adlerberth, I. 2010. Intake of Lactobacillus plantarum reduces certain gastrointestinal symptoms during treatment with antibiotics. J Clin Gastroenterol 44:106-112.

15.       Lionetti, E. M., V. L.; Castellaneta, S. P.; Magista, A. M.; de Canio, A.; Maurogiovanni, G.; Ierardi, E.; Cavallo, L.; Francavilla, R. 2006. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children: a randomized placebo controlled trial. Aliment Pharmacol Ther 24:1461-1468.

16.       Cimperman, L. B., G.; Best, K.; Diligente, A.; Mordarski, B.; Oster, M.; Smith, M.; Vatakis, F.; Wiese, D.; Steiber, A.; Katz, J. 2011. A randomized, double-blind, placebo-controlled pilot study of Lactobacillus reuteri ATCC 55730 for the prevention of antibiotic-associated diarrhea in hospitalized adults. J Clin Gastroenterol 45:785-789.

17.       Arvola, T. L., K.; Torkkeli, S.; Mykkanen, H.; Salminen, S.; Maunula, L.; Isolauri, E. 1999. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 104:e64.

18.       Armuzzi, A. C., F.; Ojetti, V.; Bartolozzi, F.; Canducci, F.; Candelli, M.; Santarelli, L.; Cammarota, G.; De Lorenzo, A.; Pola, P.; Gasbarrini, G.; Gasbarrini, A. 2001. Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study. Digestion 63:1-7.

19.       Armuzzi, A. C., F.; Bartolozzi, F.; Canducci, F.; Candelli, M.; Ojetti, V.; Cammarota, G.; Anti, M.; De Lorenzo, A.; Pola, P.; Gasbarrini, G.; Gasbarrini, A. 2001. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther 15:163-169.

20.       Erdeve, O. T., U.; Dallar, Y. 2004. The probiotic effect of Saccharomyces boulardii in a pediatric age group. J Trop Pediatr 50:234-236.

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