Probiotic yogurt of no benefit in preventing antibiotic-associated diarrhoea
Supplementation with probiotics containing the combined LA-5, BB-12 and LC-01 strains does not effectively prevent antibiotic-associated diarrhoea in hospitalized patients, a study has shown.
The study randomized 314 hospitalized patients (mean age 76 years) to receive on a daily basis 200 mL of placebo-yogurt (Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus), 200 mL of probiotic yogurt (previous plus Lactobacillus acidophilus La-5, Bifidobacterium animalis subsp. lactis Bb-12 and Lactobacillus casei subsp. casei Lc-01) or no yogurt (unblinded control) within 48 hours of initiating antibiotic therapy and up to 5 days after stopping the antibiotic.
During the 1-month follow-up, diarrhoea occurred in 23.0 percent of patients in the probiotic group vs 17.6 percent in the placebo group (absolute risk reduction, –5.35 percent; 95 percent CI, –15.4 to 4.7; p=0.30). The rate did not significantly differ in the unblinded external control and in the blinded study groups combined (20.9 percent vs 20.2 percent, respectively; p=0.91).
Duration of diarrhoea, maximum number of bowel movements or prolonged admission because of diarrhoea were similar among the groups. All-cause mortality rates were also comparable.
The findings provide no clear evidence of the benefit of using probiotics as prophylaxis for antibiotic-associated diarrhoea, researchers said.
The appeal of using probiotics stems from their accessibility, affordability and acceptable known safety profile. However, available data make it difficult to draw any solid conclusion about their role in antibiotic-associated diarrhoea. It would be reasonable to recommend probiotics in certain populations such as patients with a history or risk factors for such a condition. [World J Gastroenterol 2014;20:17788-17795]