Can probiotics help treat antibiotic-related infection?

Posted on November 4, 2014   by Benjamin Thompson

If you go down to your local supermarket today, you shouldn’t be surprised if you find a wide array of probiotic-based products (mainly yoghurts), each associated with claims that they will improve your dietary health. Whether probiotics actually provide any specific health benefits remains hotly debated.

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One area where probiotics do seem to make a difference is in preventing Antibiotic Associated Diarrhoea (AAD), which can be a serious problem, particularly in healthcare settings. A 2013 Cochrane review, which compared the results from 31 randomised trials, suggests that probiotics, when taken together with antibiotics, can reduce the risk of C. difficile-associated diarrhoea by 64%.

Adding further evidence that probiotics have a positive effect on AAD are the results from a double blind, placebo-controlled trial, published recently in the JMM Case Reports. These results show that patients who took a probiotic that contained specific strains of Bacillus bacteria had significantly lower levels of AAD than patients from a control group who took a placebo.

The research, led by Dr Iryna Sorokulova from Auburn University, Alabama, included 271 patients in Russia who were due to take a course of broad-spectrum antibiotics for at least five days. The patients were randomised into three groups and received either: a probiotic containing a mixture of Bacillus subtilis 3 and Bacillus licheniformis 31; a probiotic containing only B. subtilis 3; or a placebo. Doses of these were given twice a day, beginning one day before the patients began taking their antibiotics and ceasing seven days after they had finished their antibiotic course.

In the group that received the Bacillus mixture, 9 out of 91 patients developed AAD, while in the single Bacillus group, 7 out of 90 patients develop AAD. These results are significantly lower than the 23 out of 90 patients in the control group that developed AAD. There were no significant differences between the two probiotic groups. In addition, those taking the probiotics reported lower levels of nausea, vomiting and abdominal pain, compared to the control group patients.

Dr Sorokulova said of the work: “The long-term prescription of broad-spectrum antibiotics will disturb the normal gut microbiota, allowing potentially hazardous species of microbes, such as Salmonella or Clostridium to grow and colonise the gut.

“These species can cause AAD, which can be a significant health problem, particularly in the elderly and those who are immunocompromised. This work shows that probiotic therapy, using specific Bacilli strains, can protect patients against AAD. I hope that these probiotic strains can be successfully used to prevent possible side effects of antibiotic treatment.”

The mixed Bacillus probiotic tested in this study is approved for clinical use in Russia and Ukraine under the name Biosporin, and is routinely used to treat acute intestinal infections. Currently, its mode of action to protect against AAD is unknown, although Bacilli are known to be a component of the normal gut microbiota.

Goldenberg J.Z., Ma S.S.Y., Saxton J.D., Martzen M.R., Vandvik P.O., Thorlund K., Guyatt G.H., & Johnston B.C. (2013). The use of probiotics to prevent C. difficile diarrhea associated with antibiotic use Cochrane Database of Systematic Reviews DOI: 10.1002/14651858.CD006095.pub3

Horosheva, T., Vodyanoy, V., & Sorokulova, I. (2014). Efficacy of Bacillus probiotics in prevention of antibiotic-associated diarrhoea: a randomized, double-blind, placebo-controlled clinical trial JMM Case Reports, 1 (3) DOI: 10.1099/jmmcr.0.004036

Image Credit: Alpha on Flickr , under CC BY-NC-SA 2.0