Your doctor has just put you on antibiotics for any one of a number of reasons. (Antibiotics are among the most widely prescribed medications worldwide, and many experts feel that antibiotics are significantly over prescribed in this country, but that's another story for another day). All of a sudden your urges become more compelling; your trips to the bathroom become more frequent. Yep, you have antibiotic associated diarrhea.
When that happens many people reach for their favorite probiotic supplement, and sometimes your doctor may even recommend that you take a probiotic along with your antibiotic. But, does it really do any good? Will it help prevent diarrhea or other symptoms associated with antibiotic use? Or, is it just a waste of money?Let's start with the basics. Antibiotics don't just kill microorganisms at the site of infection. They also wipe out the friendly bacteria in your intestine. This allows pathogenic organisms to become established in your intestine. Clostridium difficile (C. difficile) is the most common of the pathogenic organisms that colonize the intestine with antibiotic use. C. difficile causes diarrhea and a wide variety of other side effects such as abdominal cramping, nausea, fever, soft stools, flatulence (gas) and taste disturbance. If the infection is severe enough, it may require hospitalization and can even result in death.
C. difficile is a pretty bad player - one you'd probably like to avoid. So the real question is whether probiotics can prevent the C. difficile associated diarrhea that occurs with antibiotic use. The short answer is yes. And, you're probably saying you already knew that. So why am I sharing yet another study showing the probiotic use can prevent antibiotic associated diarrhea? The answer is that this isn't any ordinary study; it's a Cochrane review (Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. DOI: 10.1002/14651858.CD006095.pub3). Cochrane reviews are considered the gold standard in the medical community. Once the Cochrane Collaboration puts its seal of approval on a procedure or intervention it becomes the standard of medical care.
So let's look at this Cochrane review in more detail.
This study combined the data from 23 clinical studies with 4213 participants. The authors of the study undertook a very rigorous statistical analysis of the data from all 23 studies and came to the following conclusions:
So what is the bottom line for you?
To Your Health!
Dr. Stephen G Chaney
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.
C. difficile is a pretty bad player - one you'd probably like to avoid. So the real question is whether probiotics can prevent the C. difficile associated diarrhea that occurs with antibiotic use. The short answer is yes. And, you're probably saying you already knew that. So why am I sharing yet another study showing the probiotic use can prevent antibiotic associated diarrhea? The answer is that this isn't any ordinary study; it's a Cochrane review (Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. DOI: 10.1002/14651858.CD006095.pub3). Cochrane reviews are considered the gold standard in the medical community. Once the Cochrane Collaboration puts its seal of approval on a procedure or intervention it becomes the standard of medical care.
So let's look at this Cochrane review in more detail.
This study combined the data from 23 clinical studies with 4213 participants. The authors of the study undertook a very rigorous statistical analysis of the data from all 23 studies and came to the following conclusions:
- Probiotics reduce the risk of antibiotic associated diarrhea by 64%. That's a pretty impressive risk reduction.
- Probiotics also reduce the occurrence of many of the other side effects of antibiotic use.
- Probiotics worked equally well in children and adults, at both low and high doses, and with every probiotic species tested.
So what is the bottom line for you?
- The next time your doctor prescribes antibiotics be sure to reach for your probiotic supplement and start taking that along with the antibiotics.
- And, if you happen to get diarrhea because the food bar at your favorite restaurant is a little gamey, you'll also want to get started on a probiotic right away. (Personally, I prefer to take a probiotic on a daily basis because I never know when some bad food or bad bacteria might come my way.)
- If you just want to prevent diarrhea, it doesn't appear that you need a high potency or specialized probiotic. In the studies evaluated by the Cochrane Collaboration the bacteria most frequently used were L. acidophilis, L. casei and L. rhamnosus (and it didn't matter which one of those was used), so I would recommend that your probiotic supplement contain one of those probiotic bacteria.
- There are a lot of fancy new probiotics on the market nowadays. Some of these probiotic supplements are very high potency. And, preliminary studies suggest that these probiotic supplements may have some significant health benefits. But remember, those are just preliminary studies. Cochrane reviews stick with the tried and true - data that are supported by dozens of studies (in this case 23 studies), not just one or two studies. I will keep my eye on this evolving field and let you know when the scientific evidence shows a clear advantage for some of these newer probiotic species.
To Your Health!
Dr. Stephen G Chaney
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.
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