Can Probiotics Decrease the Risk of Antibiotic Associated Diarrhea?

Antibiotics are widely used in the prevention and treatment of various illnesses, from life-threatening infections of the blood to simple conditions like acne. While antibiotics are an effective treatment option for multiple medical issues, these medications are unfortunately associated with numerous side effects. Diarrhea is one extremely common side effect of many antibiotics.

Antibiotic associated diarrhea is particularly common in children. However, both children and adults can suffer from the onset of diarrhea during or after a course of antibiotics. The diarrhea that results as a side effect of antibiotics can last for weeks and can cause dehydration and electrolyte imbalances, create severe diaper rashes, prolong the initial illness that was being treated, and/or result in lost days from work or school.

For most cases, antidiarrheal medications are not recommended in the treatment of diarrhea resulting from antibiotic use. Individuals are often told to stay hydrated and simply let the diarrhea resolve with time. However, recent research suggests that probiotics, the healthy, bacteria normally colonized in the gut, may decrease the risk of diarrhea resulting from antibiotic use.

One recent meta-analysis evaluated 34 placebo controlled clinical trials that investigated the use of probiotics taken concurrently with antibiotic use. This meta-analysis came to intriguing conclusions about probiotic use in the prevention of antibiotic associated diarrhea:

– Probiotics given during antibiotic use was associated with an impressive 52% reduction in antibiotic-associated diarrhea.

– The benefits of probiotics were not dependent on the probiotic strains used. The yeast Saccharomyces boulardii, and bacteria Lactobacillus rhamnosus GG, Lactobacillus acidophilus, Lactobacillus bulgaricus and other strains were used alone or in combination of two or more strains. All versions of probiotics had similar protective effects.

Probiotics are very safe supplements that are available in multiple forms, liquid drops, powders, capsules or tablets. It is commonly recommended that probiotics be kept refrigerated and should be taken 2 hours before or after taking a dose of antibiotic.

Probiotics should be used with caution in people who have a compromised immune system or abnormal integrity of the intestinal mucosa, and are often avoided in the presence of a central venous catheter. However, for the vast majority of individuals, the use of probiotics while simultaneously taking antibiotic medications is a safe option that may help prevent antibiotic-associated diarrhea.

Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006;6(6):374.