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Probiotic Beneficial in the Prevention of Diarrhoea

The latest Cochrane review showed that probiotics are both safe and effective for preventing Clostridium difficile-associated diarrhea.

Antibiotics are among the most prescribed medications worldwide. Antibiotic treatment may disturb the balance of organisms that normally inhabit the gut, and may lead to reduced resistance to pathogens such as Clostridium difficile (C. difficile).  This can result in a range of symptoms, most notably, diarrhoea. Clostridium difficile is one particularly dangerous organism that may colonize the gut if the normal healthy balance has been disturbed. Clostridium difficile-related disease varies from asymptomatic infection, diarrhoea, colitis, and pseudo-membranous colitis to death. The cost of treatment is expensive and the financial burden on the medical system is substantial.

Probiotics are organisms thought to improve the balance of organisms that inhabit the gut, counteract disturbances to this balance, and reduce the risk of colonization by pathogenic bacteria.  As “functional food” or “good bacteria”, probiotics have been suggested as a means of both preventing and treating C. difficile-associated diarrhea (CDAD).

This latest Cochrane review included 31 randomized trials with a total of 4492 participants. Twenty-three studies (4213 participants) assessed the effectiveness of probiotics in preventing CDAD in participants taking antibiotics. The results suggest that when probiotics are given with antibiotics they reduce the risk of developing CDAD by 64%. Side effects were assessed in 26 studies (3964 participants) and the results suggest that probiotics decrease the risk of developing side effects. The most common side effects reported in these studies include abdominal cramping, nausea, fever, soft stools, flatulence, and taste disturbance. The short-term use of probiotics appears to be safe and effective when used along with antibiotics in patients who are not immune-compromised or severely debilitated.

Based on this systematic review and meta-analysis of randomized controlled trials, the authors concluded that probiotics are both safe and effective for preventing Clostridium difficile-associated diarrhoea.

Source: Goldenberg JZ et al. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. DOI: 10.1002/14651858.CD006095.pub3.

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