Yogurt Takes the Edge off Antibiotics

Probiotics lower rates of antibiotic associated diarrhea among people of all ages

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Diarrhea is a side effect of antibiotics killing off beneficial GI bacteria as well as pathogens. A review of recent research may shine light on a new solution to this problem.

Several trials have shown promising results at preventing antibiotic associated diarrhea by combining antibiotic treatment with probiotic supplementation.

Probiotics are microorganisms that aid the body in the process of digesting food, which can be wiped out by antibiotic treatment, leading to diarrhea and other digestive issues.

"Combining a probiotic with antibiotic treatment may prevent diarrhea."

The lead author for this study was Susanne Hempel, PhD, a scientist with the RAND Corporation working out of RAND’s Southern California Evidence-based Practice Center as a health research reviewer.

Hempel and her colleagues reviewed and analyzed current research on the effects of combining probiotics with antibiotics during February, 2012. The authors included 63 trials, which together included 11,811 participants.

Of these studies, 16 studies followed only children, from newborns to age 17, and 14 studies exclusively examined adults aged 18 to 65. Only three studies looked at elderly participants over the age of 65.

The remaining 30 studies used multiple age groups as participants. Men and women were equally represented throughout all studies.

All of the studies included in the review randomized the treatment with probiotics, and neither researchers nor participants knew whether an individual participant was receiving probiotics or a placebo.

The review found that overall, probiotics reduced the occurrence of diarrhea in participants taking antibiotics by 42 percent. It was most effective for children and adults under 65, reducing diarrhea occurrence by 45 percent in these groups.

The elderly trial participants saw less effect from probiotic treatment, with diarrhea occurrence reduced by only 20 percent. This discrepancy is likely due to the smaller number of trials focusing on the elderly.

However, until more data is produced, it appears that either antibiotics affect the elderly to a greater degree or probiotics are less effective at lessening these effects.

Often, antibiotics work too well at killing bacteria. The effects are like getting a chainsaw when you only need a scalpel. Beneficial bacteria play an important role in digestion, and are often casualties of the antibiotics along with the bacteria that cause illness.

Killing “good” bacteria disrupts normal digestion and can cause diarrhea. Antibiotic associated diarrhea affects up to 30 percent of people taking antibiotics. This can lead people to stop their treatment, thus slowing their recovery.

According to Hempel and her team, probiotics offer an excellent option for dealing with the diarrhea caused by antibiotic use. In all the studies reviewed, there were no significant adverse effects associated with probiotic treatment, so it appears that probiotics offer a safe method for dealing with this problem.

The authors identified several problems with the research they reviewed. On the whole, very few of the reviewed studies differentiated what antibiotics the participants were taking, or what strains of bacteria were used in the accompanying probiotics. The authors suggest that future research make clear what antibiotics and bacterial strains are used to better understand the relationship between these variables.

However, due to the lack of side effects and success rate, Hempel and her team recommend probiotic treatment be paired with antibiotic treatment to prevent diarrhea.

In addition to probiotic supplements many foods contain probiotics. Cultured and fermented foods are tasty ways to bring probiotics into your diet. Examples of these kinds of foods include milk products like yogurt and kefir, vegetables like sauerkraut and kimchi, as well as a cultured tea called kombucha.

This was a review and analysis of current clinical research, and will be published in the May 9 issue of the Journal of the American Medical Association. The RAND Corporation provided funding for this research. There were no reported conflicts of interest.

Reviewed by: 
Review Date: 
May 8, 2012
Last Updated:
May 9, 2012