Specific probiotic combination excerting a synergistic effect against antibiotic-associated diarrhea during and after an antibiotic therapy, a randomized double-blind placebo controlled trial.

Greet Vanheule

Abstract

Antibiotic treatment (AB) has been associated with disruption of microbiota, killing or suppressing antibiotic-sensitive bacteria and stimulating opportunistic bacteria (1- 3). This disbalance can be linked to antibiotic-associated diarrhea (AAD) occurring up to 8 weeks after AB (1, 2, 4, 5). As probiotics are known to maintain or restore the gut micro-ecology, this trial investigated the possible synergistic effect of a specific probiotic preparation containing Lactobacillus acidophilus NCFM , Bifidobacterium lactis BI07, BI04, Lactobacillus paracasei Lpc-37 and Saccharomyces boulardii, compared to Saccharomyces boulardii alone and Placebo. 121 patients under Amoxycillin/Clavulanic acid were administered either the probiotic combination (Probactiol® duo, n=42), Saccharomyces boulardii (n=39) or Placebo (n=40) from the start of AB until 1 to 3 months after the end of the AB (end of trial, EOT). At the start, end of AB and EOT, stool samples were taken, the Gastro-intestinal Symptoms Rating Score (GSRS) and a daily bowel habit diary were completed.