Multispecies Probiotic May Help Prevent Diarrhea in Kids on Antibiotics

By Reuters Staff

June 22, 2022

NEW YORK (Reuters Health) - A probiotic containing eight different strains of live beneficial microorganisms may help prevent diarrhea during antibiotic treatment in children, according to a randomized, placebo-controlled study.

The results are in line with a 2019 Cochrane review that concluded probiotics as a group have a moderate protective effect on the prevention of pediatric antibiotic-associated diarrhea (AAD).

It remains unclear whether multispecies probiotic formulations can prevent AAD, Dr. Jan Lukasik, with The Medical University of Warsaw, Poland, and colleagues note in their JAMA Pediatrics report.

The probiotic formulation they tested consists of Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Lactobacillus acidophilus W37, L acidophilus W55, Lactocaseibacillus paracasei W20, Lactoplantibacillus plantarum W62, Lactocaseibacillus rhamnosus W71, and Ligilactobacillus salivarius W24, for a total dose of 10 billion colony-forming units daily.

A total of 350 children (mean age, 50 months) were recruited within 24 hours of starting a broad-spectrum systemic antibiotics and randomly assigned to the probiotic or placebo for the duration of antibiotic treatment and for one week after.

Compared with placebo, the multispecies probiotic did not reduce the risk of AAD when analyzed according to the most stringent definition - three or more loose or watery stools per day in a 24-hour period caused by Clostridioides difficile or unknown etiology (the primary outcome).

However, the probiotic did reduce the overall risk of diarrhea regardless of the etiology from 32% to 20%, a statistically significant difference, with a number needed to benefit of nine, the study team reports.

"Therefore, the use of the studied probiotic may be considered for diarrhea prevention during antibiotic treatment in children. Our study also shows that the AAD outcome definition has a significant effect on clinical trial results and their interpretation," the researchers conclude.

Both the placebo and the probiotic preparation were manufactured and provided for study purposes by Winclove Probiotics B.V. (Amsterdam, the Netherlands), free of charge. Three authors have received nonfinancial support or grants from the company.

SOURCE: JAMA Pediatrics, online June 21, 2022.