Home News Probiotics aid in restoring the microbiota after antibiotics

Probiotics aid in restoring the microbiota after antibiotics

Antibiotics are among the most important drugs to combat infectious diseases. However, they do not only eliminate pathogens but also kill our beneficial bacteria, disturbing the balance in our intestines1,2,3. Probiotics can help to diminish these disturbances. 4,5,6,7.

During antibiotic use the disturbed bacterial population in our intestines enable pathogens to overgrow and cause antibiotic associated diarrhoea 8,9,10.  After antibiotic use, our friendly flora recovers but the original composition and diversity are not fully restored. Some bacterial groups do not even return at all 11,12,13.

These permanent disturbances are linked to all kinds of health conditions such as inflammatory bowel diseases, obesity, irritable bowel syndrome, colon cancer and even allergies 14,15,16,17,18. Particularly in vulnerable groups such as children, elderly and patients suffering from chronic disease, antibiotics most severely affect health 19,20,21,22,23.

Fortunately, antibiotic-induced disturbances can to some extent be restored by re-introducing the beneficial bacteria in our gut. For example, by administering specific probiotics,24,25,26,27. Probiotic bacteria can help recover the microbial populations and their activity, inhibit the growth of pathogenic bacteria, restore the intestinal barrier function and stimulate the immune system 28,29,30.

Their effect on reducing the risk of diarrhoea and reversing microbiota imbalances, have been proven in several studies 31,32,33. What is more, probiotics come with no or negligible side-effects and their use has been proven safe among even vulnerable patient groups 34,35,36.

Prevention is better than cure. However when antibiotics are deemed necessary, probiotics can lower future health care expenses, morbidity and mortality by restoring the microbial disturbances. And maybe even more important, improve the patient’s quality of life.

 

References

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Goldenberg JZ, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827.

Blaser M. Antibiotic overuse: Stop the killing of beneficial bacteria. Nature 2011;476:393-4.

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Pattani R, et al. Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta-analysis. Open Medicine 2013;7 (2):31-9.

Hempel S, Newberry SJ, Maher AR, Wang Z, Miles JN, Shanman R, Johnsen B, Shekelle PG. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. JAMA. 2012 May 9;307(18):1959-69.

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Dethlefsen L, Huse S, Sogin ML, Relman DA. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing. PLoS Biol. 2008;6:e280

Rashid MU, Zaura E, Buijs MJ, Keijser BJ, Crielaard W, Nord CE, et al. Determining the long-term effect of antibiotic administration on the human normal intestinal microbiota using culture and pyrosequencing methods. Clin Infect Dis. 2015;60:S77–84

Zaura E, Brandt BW, Teixeira de Mattos MJ, Buijs MJ, Caspers MP, Rashid MU, et al. Same exposure but two radically different responses to antibiotics: resilience of the salivary microbiome versus long-term microbial shifts in feces. mBio. 2015;6:e01693–15.

Young VB, Schmidt TM. Antibiotic-associated diarrhea accompanied by large-scale alterations in the composition of the fecal microbiota. J Clin Microbiol. 2004;42:1203–6.

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Angelakis E, Million M, Kankoe S, et al. Abnormal weight gain and gut microbiota modifications are side effects of long-term doxycycline and hydroxychloroquine treatment. Antimicrob Agents Chemother 2014;58:3342-7.

Hoskin-Parr L, Teyhan A, Blocker A, Henderson AJ. Antibiotic exposure in the first two years of life and development of asthma and other allergic diseases by 7.5 yr: a dose-dependent relationship. Pediatr Allergy Immunol 2013;24:762-71.

Ianiro G, Tilg H, Gasbarrini A. Antibiotics as deep modulators of gut microbiota: between good and evil. Gut. 2016 Nov;65(11):1906-1915.

Nobel YR, Cox LM, Kirigin FF, Bokulich NA, Yamanishi S, Teitler I, et al. Metabolic and metagenomic outcomes from early-life pulsed antibiotic treatment. Nat Commun. 2015;6:7486.

Saari A, Virta LJ, Sankilampi U, Dunkel L, Saxen H. Antibiotic exposure in infancy and risk of being overweight in the first 24 months of life. Pediatrics. 2015;135:617–26.

Greenwood C, Morrow AL, Lagomarcino AJ, et al. Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter. J Pediatr 2014;165:23-9.

O’Sullivan O, Coakley M, Lakshminarayanan B, et al. Alterations in intestinal microbiota of elderly Irish subjects post-antibiotic therapy. J Antimicrob Chemother 2013;68:214-21.

Rutten NB, Rijkers GT, Meijssen CB, Crijns CE, Oudshoorn JH, van der Ent CK, Vlieger AM. Intestinal microbiota composition after antibiotic treatment in early life: the INCA study. BMC Pediatr. 2015 Dec 9;15:204.

Koning CJ, Jonkers DM, Stobberingh EE, Mulder L, Rombouts FM, Stockbrügger RW. The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin. Am J Gastroenterol. 2008 Jan;103(1):178-89.

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Braon P.A, Kleerebezem M, Brummer RJ, Cani PD, Mercenier A, MacDonald TT, Garcia-Ródenas CL,Wells Can probiotics modulate human disease by impacting intestinal barrier function?JM. Br J Nutr. 2017 Jan 14; 117(1): 93–107.

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