Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: A double-blind, placebo-controlled pilot study

Madden, Jennifer A.J.; Plummer, Susan F.; Tang, James; Garaiova, Iveta; Plummer, Nigel T.; Herbison, Mary; Hunter, John O.; Shimada, Takashi; Cheng, Lei; Shirakawa, Taro

doi:10.1016/j.intimp.2005.02.006

Cited by 86Probiotics and Fermented FoodsGut microbiota and healthGastrointestinal motility and disorders

Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: A double-blind, placebo-controlled pilot study

Madden, Jennifer A.J., Plummer, Susan F., Tang, James, Garaiova, Iveta, Plummer, Nigel T., Herbison, Mary, Hunter, John O., Shimada, Takashi +2 more·2005·International Immunopharmacology

DOI 10.1016/j.intimp.2005.02.006

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Abstract

In this pilot-scale, double-blind, placebo-controlled trial, 30 patients with Helicobacter pylori infection were randomised into three groups prior to their 7 days eradication therapy, to study the effects of probiotic supplement comprising Lactobacillus acidophilus and Bifidobacterium bifidum on the intestinal microflora in response to antibiotic therapy. Group I received the placebo product from day 1 to day 15, Group II received placebo from day 1 to day 7 and probiotics from day 8 to day 15 and Group III received probiotics from day 1 to day 15. Patients provided stool samples for analysis on days 1, 7, 12, 17 and 27. For patients in Groups I and II, significant increases in the facultative anaerobe component of the microflora occurred between days 1 and 7. In Group I, the numbers remained elevated to day 27 but in Group II, the numbers decreased significantly between days 7 and 27 back to the starting levels. In Group III, the facultative anaerobe population remained stable throughout. The total anaerobe numbers increased significantly at day 27 than at day 1 for Group I, were unchanged throughout for Group II and decreased significantly for the patients in Group III between days 1 and 7 before reverting to the starting levels by day 27. From these results, it can be seen that probiotic supplementation modulates the response of the intestinal microflora to the effects of antibiotic therapy.

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Clinical trials have demonstrated that the inclusion of Lactobacillus strains CUL-60 and CUL-21 modulated facultative anaerobes during antibiotic therapy.
“Clinical trials, however, have demonstrated that the inclusion of the Lactobacillus strains CUL-60 and CUL-21 modulated the facultative anaerobes (Enterobacteriaceae, Enteroccus/Streptococcus and Staphylococcus species) during antibiotic therapy [24,55].”
From An Exploratory Investigation of Endotoxin Levels in Novice Long Distance Triathletes, and the Effects of a Multi-Strain Probiotic/Prebiotic, Antioxidant Intervention (2016) · cites this paper as [55]

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Microbiological Considerations for Probiotic Supplemented Foods
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“Beneficial health effects extend by probiotics is due to maintenance of the equilibrium of indigenous microbiota [11] with the growth inhibition of pathogenic microorganisms and boosting of innate and acquired immunity [12].”
Background
Probiotics in the prevention of clinical manifestations of common infectious diseases in children and in the elderly
Hatakka, K. (2007) · Työväentutkimus Vuosikirja · Cited by 8 · see citing works
Low-cost electrochemical sensor based on montmorillonite for antibiotic tetracycline hydrochloride detection
Guo, Q., Yang, X., Chen, Z., Wang, G., Yao, L., & Lin, Z. (2021) · Journal of Materials Science Materials in Electronics · doi:10.1007/s10854-021-07316-0 · Cited by 7 · see citing works
“Moreover, continued consumption of food containing sublethal level of antibiotics may also cause anaphylactic reactions in sensitive people [9], affect the normal activities of intestinal flora [10], and even induce hepatotoxicity [11].”
Background
Effect of Treadmill Exercise and Probiotic Ingestion on Motor Coordination and Brain Activity in Adolescent Mice
Kim, J.-C., Yoon, B., & Jeon, Y. K. (2020) · Healthcare · doi:10.3390/healthcare9010007 · Cited by 7 · see citing works
“Previous studies have indicated that probiotics significantly influence immune function [9,10] by increasing immune cell proliferation and sensitivity to external antigens [11,12].”
Background
Use of a multi-species probiotic
Lang, F. C. (2010) · Nutrafoods · doi:10.1007/bf03223333 · Cited by 7 · see citing works
The role of probiotics in Helicobacter pylori infection
Myllyluoma, E. (2007) · Työväentutkimus Vuosikirja · Cited by 7 · see citing works
The impact of probiotics and vitamin C on the prevention of upper respiratory tract symptoms in two preschool children cohorts
Paduchová, Z., Nagyová, Z., Wang, D., & Muchová, J. (2024) · Nutrition Research and Practice · doi:10.4162/nrp.2024.18.1.98 · Cited by 6 · see citing works
Maternal low-intensity exercise and probiotic ingestion during pregnancy improve physical ability and brain function in offspring mice
Kim, J.-C., & Lee, S. (2022) · Journal of Functional Foods · doi:10.1016/j.jff.2022.105311 · Cited by 5 · see citing works
Common Nutrient Depletions Caused by Pharmaceuticals
Meletis, C. D., & Zabriskie, N. (2007) · Alternative and Complementary Therapies · doi:10.1089/act.2006.13102 · Cited by 5 · see citing works
Probiotics and virus infections : The effects of Lactobacillus rhamnosus GG on respiratory and gastrointestinal virus infections
Lehtoranta, L. (2012) · Työväentutkimus Vuosikirja · Cited by 5 · see citing works
Early-life antibiotic exposures: Paving the pathway for dysbiosis-induced disorders
Attiq, A. (2025) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2025.177298 · Cited by 4 · see citing works
Sequencing analysis and characterization of the plasmid pBIF10 isolated from Bifidobacterium longum
Ma, Y., Xie, T., Hu, Q., Qiu, Z., & Song, F. (2014) · Canadian Journal of Microbiology · doi:10.1139/cjm-2014-0581 · Cited by 4 · see citing works
“Because of their beneficial effects on the health of host, bifidobacteria have attracted the attention of scientists (Bartosch et al. 2005; Kliegman 2005; Kliegman and Willoughby 2005; Madden et al. 2005).”
Background
Practices and Trends in the Prescription of Probiotics: A Detailed Analysis in an Eastern European Region
Scărlătescu, A. I., Velescu, B. Ș., Apetroaei, M.-M., Nedea, M. I., Udeanu, D. I., & Arsene, A. L. (2024) · Processes · doi:10.3390/pr12091856 · Cited by 3 · see citing works
Gastrointestinal Benefits of Probiotics
Ouwehand, A. C. (2019) · CRC Press eBooks · doi:10.1201/9780429057465-25 · Cited by 3 · see citing works
Multispecies probiotics and antibiotic-associated side effects : pathophysiological and clinical evidence
Koning, C. J. (2010) · doi:10.26481/dis.20100604ck · Cited by 3 · see citing works
Short-term and long-term alterations of gastrointestinal microbiota with different H. pylori eradication regimens: A meta-analysis
Chen, B., Li, X.-M., Cai, T., & Wang, F. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.913384 · Cited by 2 · see citing works
Functional Dairy Products and Probiotics in Infectious Diseases
Çırak, M. Y. (2009) · CRC Press eBooks · doi:10.1201/9781420082081-c14 · Cited by 2 · see citing works
Probiotics in Paediatric Disorders
Kaur, I. P., Chopra, A., & Chopra, K. (2006) · International Journal of Pharmaceutical Medicine · doi:10.2165/00124363-200620010-00004 · Cited by 2 · see citing works
“[24] Madden et al.[58] reported that probiotic supplementation modulates the response of the intestinal microflora to the effects of antibiotic therapy.”
Background
The Impact of Probiotic Supplementation on the Development of the Infant Gut Microbiota: An Exploratory Follow-Up of a Randomised Controlled Trial
Coates, N., John, D. A., Jordan, S. E., Storey, M., Thornton, C. A., Garaiová, I., Wang, D., Allen, S. J., Michael, D. R., Plummer, S., et al. (2025) · Microorganisms · doi:10.3390/microorganisms13050984 · Cited by 1 · see citing works
“…their arrival at the laboratory, with selective agars used to quantify viable Lactobacilli , Bifidobacteria , Enterobacter , Enterococci , Bacteroides , Staphylococci , Streptococci , and Clostridia , as well as yeast, total aerobes, and total anaerobes, following the method of Madden et al. [26].”
Probiotics and Antibiotic-Associated Diarrhea and Clostridium difficile Infection
Surawicz, C. M. (2009) · Springer eBooks · doi:10.1007/978-0-387-79058-9_21 · Cited by 1 · see citing works
Probiotics Usage in Childhood Helicobacter pylori Infection
Anania, C., Celani, C., Chiesa, C., & Pacifico, L. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-802189-7.00051-4 · Cited by 1 · see citing works
Functional dairy products for gastrointestinal infections and dysfunction
Myllyluoma, E., Kajander, K., & Saxelin, M. (2007) · Elsevier eBooks · doi:10.1533/9781845693107.1.63 · Cited by 1 · see citing works
Undersökning av potentiella probiotiska organismer i tarmmikroflora hos häst med speciell hänsyn till Lactobacillus spp.
Bohlin, M. (2006) · Epsilon Archive for Student Projects (University of Southampton) · Cited by 1 · see citing works
Development of an ecological model to predict risk for acquisition of Clostridium difficile-associated diarrhea during acute care hospitalization
Steele, S. E. (2008) · Digital Commons - University of South Florida (University of South Florida)
Gut microbiota and atopic manifestations in infancy
Penders, J. (2007) · doi:10.26481/dis.20070330jp
Hevosen ruokinta, terveys ja suolistomikrobisto
Huttunen, A. (2013) · Theseus (Ammattikorkeakoulujen)
Respiratory/ENT system
Galvin, K., & Bishop, M. (2011) · Elsevier eBooks · doi:10.1016/b978-0-7295-3955-5.10006-x
Effectiveness of probiotic Bifidobacterium animalis DN-173010 in the management of constipation-predominant irritable bowel syndrome in black South African women
Blaauw, R. (2014)
Intestinal microRNA Response to Citrobacter rodentium in the Presence and Absence of Bifidobacterium bifidum MIMBb75
Wen, B. (2015) · TSpace (University of Toronto)
Positive Effects of Probiotics on Motor Coordination and Brain during Moderate and High-Intensity Exercise in Adolescent Female Mice
Park, K., & Kim, J.-C. (2021) · Physikalische Medizin Rehabilitationsmedizin Kurortmedizin · doi:10.1055/a-1493-4911
“This result is consistent with previous findings that probiotics and exercise increase GABA [15, 42].”
Result
Probiotics
Kuhad, A., Kaur, I. P., Chopra, K., & Garg, A. (2009) · CRC Press eBooks · doi:10.1201/9781420062151.ch18
Probiotics in Infectious Diseases
Fong, I. W. (2009) · Springer eBooks · doi:10.1007/978-0-387-84841-9_10
Urinary system
Galvin, K., & Bishop, M. (2011) · Elsevier eBooks · doi:10.1016/b978-0-7295-3955-5.10009-5
Introduction
Sanders, M. E. (2014) · ASM Press eBooks · doi:10.1128/9781555815462.ch1
Additional file 3 of Probiotic supplementation during antibiotic treatment is unjustified in maintaining the gut microbiome diversity: a systematic review and meta-analysis
Éliás, A. J., Barna, V., Patoni, C., Demeter, D., Veres, D. S., Bunduc, Ș., Erőss, B. M., Hegyi, P. J., Földvári-Nagy, L., & Lenti, K. (2023) · Figshare · doi:10.6084/m9.figshare.23714166
Application of novel biomaterials for oral probiotic
Nivethini, D., & Chitra, A. V. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-27594-4.00021-8
Additional file 1 of Probiotic supplementation during antibiotic treatment is unjustified in maintaining the gut microbiome diversity: a systematic review and meta-analysis
Éliás, A. J., Barna, V., Patoni, C., Demeter, D., Veres, D. S., Bunduc, Ș., Erőss, B., Hegyi, P., Földvári-Nagy, L., & Lenti, K. (2023) · Figshare · doi:10.6084/m9.figshare.23714160
Additional file 2 of Probiotic supplementation during antibiotic treatment is unjustified in maintaining the gut microbiome diversity: a systematic review and meta-analysis
Éliás, A. J., Barna, V., Patoni, C., Demeter, D., Veres, D. S., Bunduc, Ș., Erőss, B., Hegyi, P., Földvári-Nagy, L., & Lenti, K. (2023) · Figshare · doi:10.6084/m9.figshare.23714163
Microorganismos probióticos y la modulación inmunológica
Fierro, J. A. A., Ortega, J. A., & Contreras, J. P. R. (2006) · Universidad Industrial de Santander

Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy
Plummer, S. F., Garaiova, I., Sarvotham, T., Cottrell, S. L., Le Scouiller, S., Weaver, M. A., Tang, J., Dee, P., & Hunter, J. (2005) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2005.04.004 · Cited by 84 · see citing works
The Effect of Probiotics on Gut Microbiota during the Helicobacter pylori Eradication: Randomized Controlled Trial
Oh, B., Kim, B. S., Kim, J. W., Kim, J. S., Koh, S., Kim, B. G., Lee, K. L., & Chun, J. (2015) · Helicobacter · doi:10.1111/hel.12270 · Cited by 164 · see citing works
Influence of anti‐ Helicobacter triple‐therapy with metronidazole, omeprazole and clarithromycin on intestinal microflora
Bühling, A., Radun, D., Müller, W. A., & Malfertheiner, P. (2001) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2001.01033.x · Cited by 81 · see citing works
Effects of anti-Helicobacter pylori treatment and probiotic supplementation on intestinal microbiota
Myllyluoma, E., Ahlroos, T., Veijola, L., Rautelin, H., Tynkkynen, S., & Korpela, R. (2006) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2006.08.034 · Cited by 95 · see citing works
Effect of probiotic supplementation combined with bismuth-containing quadruple therapy on gut microbiota during Helicobacter pylori eradication: a randomized, double-blind, placebo-controlled trial
Han, Z., Li, Y., Nan, X., Zhou, T., Li, L., & Li, Y. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1484646 · Cited by 13 · see citing works

Authors: Madden, J. A. J., Plummer, S. F., Tang, J., Garaiova, I., Plummer, N. T., Herbison, M., Hunter, J. O., Shimada, T., Cheng, L., & Shirakawa, T.
Affiliations: Cultech (United Kingdom) (GB)
Addenbrooke's Hospital (GB)
Kyoto University (JP)
Corresponding author: Plummer, Susan F.
ORCID: Tang, James
Shimada, Takashi
Cheng, Lei
Venue: International Immunopharmacology
Publisher: Elsevier BV
Published: 2005-06
Volume: 5
Issue: 6
Pages: 1091-1097
ISSN: 1567-5769 (ISSN-L)
DOI: 10.1016/j.intimp.2005.02.006
OpenAlex: W2150842395
Cited by: 86
References: 27
Citations by year: 2025: 3 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 5 · 2014: 7 · 2013: 6 · 2012: 5
FWCI: 12.81
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Immunopharmacology (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: probiotics, H. pylori eradication therapy, antibiotic-induced dysbiosis, gut microbiota, Lactobacillus acidophilus, Bifidobacterium bifidum, facultative anaerobes, anaerobic bacteria, probiotic supplementation
MeSH terms: Aged, Anti-Bacterial Agents, Bacteria, Anaerobic, Double-Blind Method, Female, Humans, Intestines, Male, Middle Aged, Patient Compliance, Pilot Projects, Colony Count, Microbial, Helicobacter pylori, Helicobacter Infections, Probiotics

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Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: A double-blind, placebo-controlled pilot study

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