Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients: A Systematic Review and Meta-Analysis

Sara Blaabjerg, Daniel Maribo Artzi, Rune Aabenhus

Research output: Contribution to journalReviewResearchpeer-review

136 Citations (Scopus)
303 Downloads (Pure)

Abstract

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 to17.7% 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.
Original languageEnglish
JournalAntibiotics
Volume6
Issue number4
Pages (from-to)1-17
Number of pages17
DOIs
Publication statusPublished - 12 Oct 2017

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