~ 071707 Probiotics Help with Antibiotic-Associated Diarrhea

The July 14, 2007 issue of the British Medical Journal reported the conclusion of researchers at Imperial College and Hammersmith Hospital in London that consuming probiotic bacteria, such as are found in yogurt, kefir, and probiotic supplements, helps with diarrhea associated with antibiotic use.

Antibiotic drugs kill the body's helpful micro-organisms as well as those that are harmful. Probiotic supplements contain beneficial live bacteria that help replenish gut flora destroyed by antibiotics. Disruption of the microflora can result in diarrhea, gas, candida albicans infection, and other gastrointestinal problems. An estimated 5 to 25 percent of patients treated with antibiotics develop diarrhea, including some cases associated with Clostridium difficile, a harmful bacteria that causes mild to severe diarrhea, which can result in dehydration and even death.

For the current study, 135 men and women over the age of 50 who received antibiotics at three London hospitals were randomly divided to receive a commercially available probiotic yoghurt drink or a sterile milkshake, beginning within 48 hours of the start of antibiotic therapy and continued twice per day until one week following discontinuance of the drugs. The probiotic drink contained active cultures of Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus. Bowel movements were monitored, and stool samples analyzed in cases of diarrhea. Participants were contacted for follow up one month after discharage.

Of the 113 patients participating in the follow-up, 12% of those who received the probiotic drink had developed antibiotic-associated diarrhea compared with 34% of those that received the sterile drink. Seventeen percent of those that did not receive the probiotic had C. difficile-associated diarrhea, while there were no cases of C. difficile among those who received probiotics.

Because of the length of stay and drugs used to treat C. difficile, the researchers acknowledge that the routine use of a probiotic drink by patients receiving antibiotics would result in significant cost savings to hospitals, as well as reduce patient morbidity and mortality.

Related Health Concern: Bacterial Infections

Probiotics are bacterial cultures contained in yogurt, buttermilk, cheese, kefir, and sauerkraut, or in dietary supplements that contain friendly bacteria (such as Lactobacillus, Bifidobacterium, Eubacterium, and Propionibacterium species) normally present on skin and in vaginal, urinary, and intestinal tracts. These bacteria are essential to the proper function of the vaginal, urinary, and digestive tracts (Bengmark S 1998; Cunningham-Rundles S et al 2000; Dani C et al 2002).

Probiotics assist immune function by inhibiting harmful bacterial growth, promoting good digestion, maintaining proper pH, and enhancing immune function (Perdigon G et al 1995). Probiotics produce bacteria-inhibiting substances (natural antibiotics) and stop harmful bacteria from attaching to vaginal, urinary, and intestinal tract mucosal linings (Ochmanski W et al 1999; Vaughan EE et al 1999). Probiotics have demonstrated In vitro ability to suppress H. pylori (Cremonini F et al 2001; Drouin E 1999; Felley C et al 2003; Johnson-Henry KC et al 2004; Wang KY et al 2004). They may be useful in stopping acute infectious diarrhea (Marignani M et al 2004), urinary tract infections (Kontiokari T et al 2003; Reid G 2002), and restoring vaginal flora (Andreeva P et al 2002).

Antibiotics often destroy friendly bacteria on skin and in urinary, vaginal, and intestinal tracts. Probiotics can be used to recolonize and restore natural floral balance in organ and body systems after antibiotic treatment (Fooks LJ et al 2002; Guarner F et al 2003; Shi HN et al 2004).
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