Antibiotic-associated diarrhea: the role of probiotics in the treatment and prevention

April 5, 2021
991
Resume

Antibacterial drugs, like any drug, have certain side effects, in particular, one of them is diarrhea caused by their use. The main reasons for the development of antibiotic-associated diarrhea, forms of the disease, features of diagnosis and etiotropic treatment are considered in the article. Based on the publications of domestic and foreign researchers, data of probiotics prescription for the prevention and treatment of antibiotic-associated diarrhea are presented. Possibilities of using probiotics, in particular Bifidobacterium lactis BB-12® and Lactobacillus acidophilus LA-5®, for prevention of complications of antihelicobacter infection, their influence on glycemic control and lipid profile of patients are described.

References:

  • 1. McFarland L.V. (2008) Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiol., 3(5): 563–578. DOI:10.2217/17460913.3.5.563.
  • 2. Andreeva I.V., Stetsyuk O.U. (2018) The place of probiotics in practice guidelines for gastroenterology: reality and near-term prospects. Consil. Medicum, 20(8): 67–72 (In Rus.).
  • 3. Hickson M. (2011) Probiotics in the prevention of antibiotic-associated diarrhoea and Clostridium difficile infection. Therap. Adv. Gastroenterol., 4(3): 185–197. DOI: 10.1177/1756283X11399115.
  • 4. Tian C.F., Su B.Y., Li Y.J. et al. (2016) Management of antibiotic-associated pseudomembranous colitis in Non-hospitalized and hospitalized patients. Pak. J. Pharm. Sci., 29(5 Suppl.): 1805–1810.
  • 5. Zhang Y., Sun J., Zhang J. et al. (2018) Enzyme Inhibitor Antibiotics and Antibiotic-Associated Diarrhea in Critically Ill Patients. Med. Sci. Monit., 4(24): 8781–8788. DOI: 10.12659/MSM.913739.
  • 6. Gilbert D.N. (1995) Aspects of the safety profile of oral antimicrobial agents. Infect. Dis. Clin. Pract., 3(3): 236–245.
  • 7. Wiström J., Norrby S.R., Myhre E.B. et al. (2001) Frequency of antibiotic-associated diarrhoea in 2462 antibiotic-treated hospitalized patients: a prospective study. J. Antimicrob. Chemother., 47(1): 43–50. DOI: 10.1093/jac/47.1.43.
  • 8. Bartlett J.G. (2002) Clinical practice. Antibiotic-associated diarrhea. N. Engl. J. Med., 346(5): 334–339. DOI: 10.1056/NEJMcp011603.
  • 9. Skrypnyk I.N., Maslova A.S., Mandryka Ya.A. (2013) Modern spore-forming probiotics in the treatment of intestinal microbiocenosis disorders: efficacy and safety. Community health, 3–4: 73–81 (In Rus.).
  • 10. Alam S., Mushtaq M. (2009) Antibiotic associated diarrhea in children. Indian. Pediatr., 46(6): 491–496.
  • 11. Zvyagintseva T.D., Chernobay A.I. (2011) Antibiotic-associated diarrhea: treatment approaches. Health of Ukraine, 18: 24–25 (In Rus.).
  • 12. Zhou H., Xu Q., Liu Y., Guo L.T. (2020) Risk factors, incidence, and morbidity associated with antibiotic-associated diarrhea in intensive care unit patients receiving antibiotic monotherapy. World J. Clin. Cases, 8(10): 1908–1915. DOI: 10.12998/wjcc.v8.i10.1908.
  • 13. Maev I.V., Samsonov A.A., Golubev N.N. (2007) Antibiotic-associated diarrhea. Gastroenterology. Consilium medicum, 1: 20–24 (In Rus.).
  • 14. Khavkin A.I. (2018) Antibiotic-associated diarrhea: potential use of probiotics. Difficult patient, 16(1–2): 452 (In Rus.).
  • 15. Hookman P., Barkin S.J. (2009) Clostridium difficile associated infectition, diarrhea and colitis. World J. Gastroenterol.,15(13): 1554–1580. DOI:10.3748/wjg.11554.
  • 16. Gazzola A., Panelli S., Corbella M. et al. (2020) Microbiota in Clostridioides difficile-Associated Diarrhea: Comparison in Recurrent and Non-Recurrent Infections. Biomedicines, 8(9): E335. DOI:10.3390/biomedicines8090335.
  • 17. De Roo A.C., Regenbogen S.E. (2020) Clostridium difficile Infection: An Epidemiology Update. Clinics in colon and rectal surgery, 33(2): 49–57 (https://doi.org/10.1055/s-0040-1701229).
  • 18. Hell M., Bernhofer C., Stalzer P. et al. (2013) Probiotics in Clostridium difficile infection: reviewing the need for a multistrain probiotic. Beneficial Microbes, 4(1): 39–35. DOI: 10.3920/BM2012.0049.
  • 19. Allen S.J., Wareham K., Wang D. et al. (2013) Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet, 382(9900): 1249–1257. DOI: 10.1016/S0140-6736(13)61218-0.
  • 20. Kukla M., Adrych K., Dobrowolska A. et al. (2020) Guidelines for Clostridium difficile infection in adults. Prz Gastroenterol., 15(1): 1–21. DOI: 10.5114/pg.2020.93629.
  • 21. McDonald L.C., Gerding D.N., Johnson S. et al. (2018) Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin. Infect. Dis., 66(7): e1–e48. DOI: 10.1093/cid/cix1085.
  • 22. Lupse M., Flonta M., Cioara A. (2013) Predictors of first recurrence in Clostridium difficile-associated disease. A study of 306 patients hospitalized in a Romanian tertiary referral center. J. Gastrointestin. Liver Dis., 22(4): 397–403. DOI:10.1093/cid/cis356.
  • 23. Hill C., Guarner F., Reid G. et al. (2014) The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat. Rev. Gastroenterol. Hepatol., 11(8): 506–514. DOI: 10.1038/nrgastro.2014.66.
  • 24. FAO/WHO (2012) Report of a Joint FAO/WHO Working group. Guidelines for evaluation of probiotics in food. London, Ontario, Canada.
  • 25. Glushanova N.A. (2003) Biological properties of Lactobacillus. Bulletin of Siberian Medicine, 2(4): 50–58 (In Rus.).
  • 26. Novik I. (2006) Bifidobacterium: scientific basis for practical use. Health and environmental issues, 3(9): 144–151 (In Rus.).
  • 27. Markowiak P., Śliżewska K. (2017) Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients, 9(9): 1021. DOI: 10.3390/nu9091021.
  • 28. Collado M.C., Meriluoto J., Salminen S. (2007) Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus. Lett. Appl. Microbiol., 45: 454–460. DOI: 10.1111/j.1472-765X.2007.02212.x.
  • 29. Martins F.C., Silva A.A., Vieira A.T. et al. (2009) Comparative study of Bifidobacterium animalis, Escherichia coli, Lactobacillus casei and Saccharomyces boulardii probiotic properties. Arch. Microbial., 191(8): 623–630. DOI: 10.1007/s00203-009-0491-x.
  • 30. Andreeva I.V., Stetsyuk O.U. (2016) Efficacy and safety of the combination of Lactobacillus acidophilus LA-5 and Bifidobacterium lactis BB-12 in gastroenterology, pediatrics and allergology. Clinical Microbiology and Antimicrobial Chemotherapy, 18(2): 113–124 (In Rus.).
  • 31. Zeinhom M., Tellez A.M., Delcenserie V. et al. (2012) Yoghurt containing bioactive molecules produced by Lactobacillus acidophilus La-5 exerts a protective effect against enterohemorrhagic Escherichia coli (EHEC) in mice. J. Food Prot., 10: 1796–1805. DOI:10.4315/0362-028X.JFP-11-508.
  • 32. Medellin-Pena M.J., Griffiths M.W. (2009) Effect of molecules secreted by Lactobacillus acidophilus strain La-5 on Escherichia coli 0157:H7 colonization. Applied and Environmental Microbiology, 75(15): 1165–1172. DOI: 10.1128/AEM.01651-08.
  • 33. Juntunen M., Kirjavainen P.V., Ouwehand A.C. et al. (2001) Adherence of probiotic bacteria to human intestinal mucus in healthy infants and during rotavirus infection. Clin. Diagn. Lab. Immunol., 8(2): 293–296. DOI: 10.1128/CDLI.8.2.293-296.2001.
  • 34. Ouwehand A.C., Salminen S., Tölkkö S. et al. (2002) Resected human colonic tissue: new model for characterizing adhesion of lactic acid bacteria. Clin. Diagn. Lab. Immunol., 9: 184–186. DOI: 10.1128/cdli.9.1.184-186.2002.
  • 35. Kekkonen R. (2008) Immunomodulatory Effects of Probiotic Bacteria In Healthy Adults. Academic Dissertation. Helsinki, 122 p.
  • 36. Jungersen M., Wind A., Johansen E. et al. (2014) The science behind the probiotic strain Bifidobacterium animalis subsp. Lactis BB-12R. Microorganisms, 2: 92–110. DOI:10.3390/microorganisms2020092.
  • 37. Zhang D.Y., Pan Z.Y., Yu X.K. et al. (2019) Bifidobacterium lactis BB-12 Attenuates Macrophage Aging Induced by D-Galactose and Promotes M2 Macrophage Polarization. J. Immunol. Res., 2019: 4657928. DOI: 10.1155/2019/4657928.
  • 38. Singer M.Ya., Pidgorsky V.S., Lazarenko L.M. et al. (2009) Influence of lacto- and bifidobacteria on the indicators of immunoreactivity of the organism in the experimental model. Microbiology and biotechnology, 1(5): 39–48 (In Ukr.).
  • 39. Anitha M., Vijay-Kumar M., Sitaraman S.V. et al. (2012) Gut microbial products regulate murine gastrointestinal motility via Toll-like receptor 4 signaling. Gastroenterology, 143(4): 1006–1016. DOI: 10.1053/j.gastro.2012.06.034.
  • 40. Eskesen D., Jespersen L., Michelsen B. et al. (2015) Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial. Br. J. Nutr., 114: 1638–1646.
  • 41. Li S.-Ch., Hsu W.-F., Chang J.-S., Shih Ch.-K. (2019) Combination of Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis Shows a Stronger Anti-Inflammatory Effect than Individual Strains in HT-29 Cells. Nutrients, 11(5): 969. doi: 10.3390/nu11050969.
  • 42. Gong Y., Li Y., Sun Q. (2015) Probiotics improve efficacy and tolerability of triple therapy to eradicate Helicobacter pylori: a meta-analysis of randomized controlled trials. Int. j. Сlin. Еxp. Med., 8(4): 6530–6543.
  • 43. Blaabjerg S., Artzi D.M., Aabenhus R. (2017) Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients — A Systematic Review and Meta-Analysis. Antibiotics (Basel), 6(4): 21. DOI: 10.3390/antibiotics6040021.
  • 44. Guo Q., Goldenberg J.Z., Humphrey C. et al. (2019) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst. Rev., 4(4): CD004827. DOI: 10.1002/14651858.CD004827.pub5.
  • 45. Videlock E.J., Cremonini F. (2012) Meta-analysis: probiotics in antibiotic-associated diarrhoea. Aliment. Pharmacol. Ther., 35(12): 1355–1369. DOI: 10.1111/j.1365-2036.2012.05104.x.
  • 46. Lü M., Yu S., Deng J. et al. (2016) Efficacy of Probiotic Supplementation Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials. PLoS One, 11(10): e0163743. DOI: 10.1371/journal.pone.0163743.
  • 47. De Vrese M., Kristen H., Rautenberg P. et al. (2011) Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J. Dairy Res., 78(4): 396–403. DOI: 10.1017/S002202991100063X.
  • 48. Fang H.R., Zhang G.Q., Cheng J.Y. et al. (2019) Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori infection in children: a meta-analysis of randomized controlled trials. Eur. J. Pediatr., 178(1): 7–16. DOI: 10.1007/s00431-018-3282-z.
  • 49. Guarner F., Sanders M.E., Eliakim R. et al. (2017) Probiotics and prebiotics: WGO Global Guidelines. 36 p.
  • 50. Plotnikova E.Yu., Zakharova Yu.V., Gracheva T.Yu. (2017) Possibilities of using Linex Forte® in clinical practice. Med. advice, 5: 94–98 (In Rus.).
  • 51. Chatterjee S., Kar P., Das T. et al. (2013) Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J. Assoc. Physicians India, 61(10): 708–712.
  • 52. Fox M.J., Ahuja K.D., Robertson I.K. et al. (2015) Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study. BMJ Open, 5(1): e006474. DOI: 10.1136/bmjopen-2014-0074.
  • 53. Martin C.R., Osadchiy V., Kalani A., Mayer E.A. (2018) The Brain-Gut-Microbiome Axis. Cell Mol. Gastroenterol. Hepatol., 6(2): 133–148. DOI: 10.1016/j.jcmgh.2018.04.003.
  • 54. Carabotti M., Scirocco A., Maselli M.A., Severi C. (2015) The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Ann. Gastroenterol., 28(2): 203–209.
  • 55. Chunchai T., Thunapong W., Yasom S. et al. (2018) Decreased microglial activation through gut-brain axis by prebiotics, probiotics, or synbiotics effectively restored cognitive function in obese-insulin resistant rats. J. Neuroinflammation, 15(1): 11. DOI: 10.1186/s12974-018-1055-2.
  • 56. Yang C., Fujita Y., Ren Q. et al. (2017) Bifidobacterium in the gut microbiota confer resilience to chronic social defeat stress in mice. Sci. Rep., 7: 45942. DOI: 10.1038/srep45942.
  • 57. Wang L., Guo M. J., Gao Q. et al. (2018) The effects of probiotics on total cholesterol: a meta-analysis of randomized controlled trials. Medicine (Baltimore), 97(5): e9679. DOI:10.1097/MD.0000000000009679.
  • 58. Mo R., Zhang X., Yang, Y. (2019) Effect of probiotics on lipid profiles in hypercholesterolaemic adults: a meta-analysis of randomized controlled trials. Medicina Clínica, 152(12): 473–481. DOI: 10.1016/j.medcli.2018.09.007.
  • 59. Klaver F.A., van der Meer R. (1993) The assumed assimilation of cholesterol by Lactobacilli and Bifidobacterium bifidum is due to their bile salt-deconjugating activity. Appl. Environ. Microbiol., 59: 1120–1124.
  • 60. Pereira D.I., Gibson G.R. (2002) Effects of consumption of probiotics and prebiotics on serum lipid levels in humans. Crit. Rev. Biochem. Mol. Biol., 37: 259–281. DOI: 10.1080/10409230290771519.
  • 61. Ejtahed H.S., Mohtadi-Nia J., Homayouni-Rad A. et al. (2011) Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. J. Dairy Sci., 94(7): 3288–3294. https://doi.org/10.3168/jds.2010-4128.
  • 62. Tonucci L.B., Olbrich Dos Santos K.M., de Oliveira L.L. (2017) Clinical application of probiotics in type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study. Clin. Nutr., 36(1): 85–92. https://doi.org/10.1016/j.clnu.2015.11.011
  • 63. Kocsis T., Molnár B., Németh D. et al. (2020) Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials. Sci. Rep., 10(1): 11787. https://doi.org/10.1038/s41598-020-68440-1.