Probiotics for the prevention of antibiotic-associated diarrhoea in older patients: a systematic review
Abstract
Objective Here, we evaluated the efficacy of probiotic interventions in prevention of antibiotic-associated diarrhoea (AAD) and Clostridium difficile diarrhoea (CDD) in older patients.Methods PubMed, Embase, CENTRAL, CINAHL, and Web of Science were comprehensively searched from their dates of inception to May 2014. Only randomised controlled trials reporting data on probiotics including Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and Bacillus-alone or in combination-versus placebo or absence of treatment in older patients (age ≥65 years) were included. Risk ratios (RRs) for AAD and CDD relative to placebo or absence of treatment were estimated.Results Six trials with a total of 3562 patients were included. Only one trial showed that Bacillus licheniformis was effective for preventing AAD in older patients. However, there was no preventive effect for AAD and CDD with Lactobacillus acidophilus (Florajen), Lactobacillus casei Shirota, Saccharomyces cerevisiae (boulardii) lyo, mixture of Lactobacillus acidophilus and Bifidobacterium bifidum (Cultech strains), and mixture of Lactobacillus acidophilus CUL60, CUL21, Bifidobacterium bifidum CUL20 and B. lactis CUL34.Conclusions Our findings indicate that probiotics may not reduce the risk of AAD and CDD in older patients. However, with current published data, it is difficult to draw concrete conclusions. To confirm these findings, sample sizes, multi-centre, double-blind studies that consider factors such as probiotic strains and types of antibiotics are required.
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That meta-analysis analysed only 13 studies, including adults over 65 only.
“However, only 13 studies were analysed, including adults over 65 only.”
From Probiotics for the prevention of antibiotic-associated diarrhoea: A systematic review and meta-analysis (2021) · cites this paper as [40]
One meta-analysis reported that probiotics may not be effective in reducing the incidence of antibiotic-associated diarrhoea.
“Contrary to the findings of our review, one meta-analysis40 reported that probiotics may not be effective in reducing the incidence of AAD.”
From Probiotics for the prevention of antibiotic-associated diarrhoea: A systematic review and meta-analysis (2021) · cites this paper as [40]
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- Authors
- Xie, C., Li, J., Wang, K., Li, Q., & Chen, D.
- Affiliations
- The Affiliated Yongchuan Hospital of Chongqing Medical University (CN)
- Corresponding author
- Chen, Daorong
- Venue
- Travel Medicine and Infectious Disease
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 13
- Issue
- 2
- Pages
- 128-134
- ISSN
- 1477-8939 (ISSN-L)
- OpenAlex
- W2053155609
- Cited by
- 49
- References
- 56
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 2 · 2018: 5 · 2017: 7 · 2016: 2 · 2015: 5
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Travel Medicine and Infectious Disease (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Research Fund of Chongqing Municipal Health Bureau (2009-2-345)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- probiotics, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, older adults, Bacillus licheniformis, Lactobacillus, Bifidobacterium, Saccharomyces boulardii, Lactobacillus acidophilus, Bifidobacterium bifidum, probiotic strains
- MeSH terms
- Aged, Aged, 80 and over, Anti-Bacterial Agents, Diarrhea, Humans, Probiotics
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