May I Please Have Some Probiotics with my Antibiotics . . .

In June 2007, the British Medical Journal published the results of a double-blind study showing how probiotics reduced the incidence of diarrhea in patients taking antibiotics. More specifically:

Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhoea and C difficile associated diarrhoea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50.

The 135 hospital patients involved in this study had a mean age of 74, 60% of them were receiving one antibiotic and the other 40% were receiving two antibiotics. 12% of the probiotic group developed diarrhoea associated with antibiotic use compared with 19/56 (34%) in the placebo group.

The study also included a cost analysis, concluding: "Clearly substantial savings could be made by the routine use of probiotics." Some of the costs are shown below:

cost to prevent antibiotic associated diarrhea cost to prevent C difficile associated diarrhea   cost to treat C difficile or antibiotic associated diarrhea
$100 $120   $3,669

Note: Increased treatment costs are "mainly because of increased length of stay in hospital but also because of the use of vancomycin."

This study is notable because (1) it was double-blind, (2) the probiotic strains are compatible with those recommended for the specific carbohydrate diet--notably, a bifidus strain was not included in the study, and (3) the study estimated the cost of not using probiotics.

As more probiotic studies are published, the effectiveness of specific strains will become more apparent.

source: Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial,, BMJ, doi:10.1136/bmj.39231.599815.55 (published 29 June 2007)