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Intake of Lactobacillus plantarum Reduces Certain Gastrointestinal Symptoms During Treatment With Antibiotics

  • 2010-02
  • Journal of Clinical Gastroenterology 44(2)
    • Elisabet Lönnermark
    • V. Friman
    • G. Lappas
    • T. Sandberg
    • A. Berggren
    • I. Adlerberth

Abstract

Goals: To examine if intake of Lactobacillus plantarum can prevent gastrointestinal side effects in antibiotic-treated patients.

Background: Diarrhea is a common side effect of treatment with antibiotics. Some studies indicate that the risk of antibiotic-associated diarrhea can be reduced by administration of certain probiotic microorganisms.

Study: Patients treated for infections at a university hospital infectious diseases clinic were randomized to daily intake of either a fruit drink with L. plantarum 299v (10(10) colony forming units/d) or a placebo drink, until a week after termination of antibiotic treatment. Subjects recorded the number and consistency of stools as well as gastrointestinal symptoms until up to 3 weeks after last intake of test drink. Fecal samples were collected before the first intake of test drink and after termination of antibiotic therapy and analyzed for Clostridium difficile toxin.

Results: Clinical characteristics on admission were similar in the 2 groups. The overall risk of developing loose or watery stools was significantly lower among those receiving L. plantarum [odds ratio (OR), 0.69; 95% confidence interval (CI), 0.52-0.92; P=0.012], as was development of nausea (OR, 0.51; 95% CI, 0.30-0.85; P=0.0097). Diarrhea defined as > or =3 loose stools/24 h for > or =2 consecutive days was unaffected by the treatment (OR, 1.4; 95% CI, 0.33-6.0; P=0.86). No significant differences regarding carriage of toxin producing C. difficile were observed between the groups.

Conclusions: Our results indicate that intake of L. plantarum could have a preventive effect on milder gastrointestinal symptoms during treatment with antibiotics.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus plantarumNo Change in Severe Diarrhea IncidenceNeutral
Small
Lactobacillus plantarumNo Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarumReduced NauseaBeneficial
Moderate
Lactobacillus plantarumReduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum 14DReduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum 14DReduced NauseaBeneficial
Moderate
Lactobacillus plantarum DR7Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum DR7Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum DSM 6595No Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarum DSM 6595Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum DSM 6595Reduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum DSM 6595Unchanged Severe DiarrheaNeutral
Small
Lactobacillus plantarum DSM 6596No Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarum DSM 6596Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum DSM 6596Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum DSM 6596Unchanged Severe DiarrheaNeutral
Small
Lactobacillus plantarum HA-119Carriage of Toxin-Producing Clostridium DifficileNeutral
Small
Lactobacillus plantarum HA-119Increased Diarrhea IncidenceNeutral
Small
Lactobacillus plantarum HA-119Reduced Incidence of Loose or Watery StoolsBeneficial
Moderate
Lactobacillus plantarum HA-119Reduced Nausea IncidenceBeneficial
Moderate
Lactobacillus plantarum L-137No Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarum L-137No Impact on Severe DiarrheaNeutral
Small
Lactobacillus plantarum L-137Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum L-137Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum N13No Significant Effect on DiarrheaNeutral
Small
Lactobacillus plantarum N13No Significant Effect on Toxin-Producing C. difficile CarriageNeutral
Small
Lactobacillus plantarum N13Reduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum R1012Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum R1012Reduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum Rosell-1012Reduced Incidence of Loose or Watery StoolsBeneficial
Moderate
Lactobacillus plantarum Rosell-1012Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum Rosell-AReduced NauseaBeneficial
Moderate
Lactobacillus plantarum Rosell-AReduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum Rosell-AUnchanged Incidence of DiarrheaNeutral
Small
Lactobacillus plantarum SD5209No Change in Severe Diarrhea IncidenceNeutral
Small
Lactobacillus plantarum SD5209Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum SD5209Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum SD-5209No Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarum SD-5209Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum SD-5209Reduced Risk of DiarrheaBeneficial
Moderate
Lactobacillus plantarum SD-5209Unchanged Incidence of DiarrheaNeutral
Small
Lactobacillus plantarum UALp-05Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum UALp-05Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum UALp-05MNo Change in DiarrheaNeutral
Small
Lactobacillus plantarum UALp-05MNo Impact on Clostridium difficile Toxin CarriageNeutral
Small
Lactobacillus plantarum UALp-05MReduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum UALp-05MReduced NauseaBeneficial
Moderate
Lactobacillus plantarum VPro 10Reduced Incidence of Loose StoolsBeneficial
Moderate
Lactobacillus plantarum VPro 10Reduced NauseaBeneficial
Moderate
Lactobacillus plantarum VPro 10Unchanged Severe DiarrheaNeutral
Small

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