Probiotics Prevent Antibiotic-Related Diarrhea or Backfire

Antibiotic-related diarrhea is not uncommon. Among patients treated with antibacterial drugs, The incidence rate ranges from 25% to 30%, and is more common when amoxicillin/clavulanic acid antibiotics (amoxicillin) are used. Antibiotic-related Clostridium difficile infection is also not uncommon, accounting for about 1/3 of antibiotic-related diarrhea patients. Clostridium difficile has now become a part of nosocomial infection.

As over-the-counter drugs become more and more readily available, the use of probiotics has greatly increased. When patients are using antibacterial drugs, doctors even routinely recommend the use of probiotics to prevent antibiotic-related diarrhea.

However, a large-scale study (PLACIDE study) found that there was no significant difference in the incidence of Clostridium difficile infection or antibiotic-related diarrhea between probiotic group and placebo group.

Interestingly, the incidence of flatulence increased in the probiotic treatment group, while the number of flatulence reports increased threefold in patients receiving probiotic treatment for Clostridium difficile diarrhea. Probiotics did not reduce Clostridium difficile infection.

Although probiotics may seem attractive, It may not be the right choice for patients. Although the purpose of preventive use of probiotics is to rebuild health, Attempts have been made to rebuild this balance with bacteria that are considered beneficial. However, when the microbial community changes, the metabolism of carbohydrates, bile salts and complex sugars all change, and it is not clear whether allowing another bacterium to enter the intestinal tract benefits.

PLACIDE studied 1.5 hospitals, 68 internal and surgical units, and more than 17,000 antibiotic-treated patients over 65 years old. 2. Microbial agents (probiotics) were treated with placebo for 21 days by Lactobacillus and Bifidobacterium. 3. Follow-up for 8 weeks: diarrhea, Clostridium difficile; There was no difference between probiotic group and placebo group. Increase flatulence.