Effectiveness of Lactobacillus helveticus and Lactobacillus rhamnosus for the management of antibiotic-associated diarrhoea in healthy adults: a randomised, double-blind, placebo-controlled trial

• Published in: British journal of nutrition Vol. 116; no. 1; pp. 94 - 103
• Main Authors: Evans, Malkanthi, Salewski, Ryan P., Christman, Mary C., Girard, Stephanie-Anne, Tompkins, Thomas A.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 14.07.2016
• Subjects: Adult; Amoxicillin-Potassium Clavulanate Combination - adverse effects; Anti-Bacterial Agents - adverse effects; Antibiotics; Clinical trials; Diarrhea; Diarrhea - chemically induced; Diarrhea - microbiology; Double-Blind Method; Human and Clinical Nutrition; Humans; Lactobacillus helveticus; Lactobacillus rhamnosus; Microorganisms; Probiotics; Probiotics - pharmacology; Side effects; Probiotics; Antibiotic-associated diarrhoea; Diarrhoea-like defecation; Lactobacillus helveticus; Lactobacillus rhamnosus; BSS Bristol Stool Scale; CFU colony-forming units; DBHD daily bowel habits diary; GSRS Gastrointestinal Symptom Rating Scale; DLD diarrhoea-like defecations; AAD antibiotic-associated diarrhoea
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114516001665

Broad-spectrum antibiotic use can disrupt the gastrointestinal microbiota resulting in diarrhoea. Probiotics may be beneficial in managing this type of diarrhoea. The aim of this 10-week randomised, double-blind, placebo-controlled, parallel study was to investigate the effect of Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011 supplementation on antibiotic-associated diarrhoea in healthy adults. Subjects were randomised to receive 1 week of amoxicillin–clavulanic acid (875 mg/125 mg) once per day, plus a daily dose of 8×109 colony-forming units of a multi-strain probiotic (n 80) or placebo (n 80). The probiotic or placebo intervention was maintained for 1 week after completion of the antibiotic. Primary study outcomes of consistency and frequency of bowel movements were not significantly different between the probiotic and placebo groups. The secondary outcomes of diarrhoea-like defecations, Gastrointestinal Symptoms Rating Scale scores, safety parameters and adverse events were not significantly different between the probiotic intervention and the placebo. A post hoc analysis on the duration of diarrhoea-like defecations showed that probiotic intervention reduced the length of these events by 1 full day (probiotic, 2·70 (sem 0·36) d; placebo, 3·71 (sem 0·36) d; P=0·037; effect size=0·52). In conclusion, this study provides novel evidence that L. helveticus R0052 and L. rhamnosus R0011 supplementation significantly reduced the duration of diarrhoea-like defecations in healthy adults receiving antibiotics.