Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients—A Systematic Review and Meta-Analysis
Open accessAbstract
A common adverse effect of antibiotic use is diarrhea. Probiotics are living microorganisms, which, upon oral ingestion, may prevent antibiotic-associated diarrhea (AAD) by the normalization of an unbalanced gastrointestinal flora. The objective of this systematic review was to assess the benefits and harms of probiotics used for the prevention of AAD in an outpatient setting. A search of the PubMed database was conducted and yielded a total of 17 RCTs with 3631 participants to be included in the review. A meta-analysis was conducted for the primary outcome: the incidence of AAD. The pooled results found that AAD was present in 8.0% of the probiotic group compared to 17.7% in the control group (RR 0.49, 95% CI 0.36 to 0.66; I2 = 58%), and the species-specific results were similar regarding the probiotic strains L. rhamnosus GG and S. boulardii. However, the overall quality of the included studies was moderate. A meta-analysis of the ten trials reporting adverse events demonstrated no statistically significant differences in the incidence of adverse events between the intervention and control group (RD 0.00, 95% CI −0.02 to 0.02, 2.363 participants). The results suggests that probiotic use may be beneficial in the prevention of AAD among outpatients. Furthermore, the use of probiotics appears safe.
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Probiotics prevent and treat gastrointestinal infections.
“In addition to modulating the immune system, the positive health effects of taking probiotics include: the improvement of lactose tolerance and digestion [199,205], the prevention and treatment of gastrointestinal infections [206], the prevention of colorectal cancer [203,207], reduction in blood cholesterol levels [208,209,210], and the improvement of mental health via the gut-brain axis [211].”
From Lactic Acid Bacteria in Raw-Milk Cheeses: From Starter Cultures to Probiotic Functions (2022) · cites this paper as [206]
The Introduction and Results address probiotics for preventing antibiotic-associated diarrhea in outpatients, a narrower gastrointestinal outcome than preventing infections. The H. pylori subgroup in Results §2.4.2 also measures diarrhea during eradication therapy, not whether probiotics treat the infection. The paper therefore does not support the claim's broader prevention-and-treatment wording. (LLM, conf=0.80)
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- Authors
- Blaabjerg, S., Artzi, D., & Aabenhus, R.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Blaabjerg, Sara
- Artzi, Daniel
- Aabenhus, Rune
- ORCID
- Aabenhus, Rune
- Venue
- Antibiotics
- Publisher
- MDPI AG
- Published
- 2017-10-12
- Volume
- 6
- Issue
- 4
- Pages
- 21
- ISSN
- 2079-6382 (ISSN-L)
- PMC
- PMC5745464
- OpenAlex
- W2762238784
- Cited by
- 208
- References
- 29
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 27 · 2023: 24 · 2022: 31 · 2021: 27 · 2020: 32 · 2019: 25 · 2018: 7
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Antibiotics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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, antibiotic-associated diarrhea, diarrhea prevention, outpatients, Lactobacillus rhamnosus GG, Saccharomyces boulardii, adverse events, gut microbiota, antibiotic adverse effects
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