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Antibiotics 2017, 6(4), 21; https://doi.org/10.3390/antibiotics6040021

Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients—A Systematic Review and Meta-Analysis

The Research Unit for General Practice and Section of General Practice, University of Copenhagen, 1014 Copenhagen K, Denmark
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Academic Editor: Christopher C. Butler
Received: 3 August 2017 / Revised: 6 October 2017 / Accepted: 10 October 2017 / Published: 12 October 2017
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Abstract

A common adverse effect of antibiotic use is diarrhea. Probiotics are living microorganisms, which, upon oral ingestion, may prevent antibiotic-associated diarrhea (AAD) by the normalization of an unbalanced gastrointestinal flora. The objective of this systematic review was to assess the benefits and harms of probiotics used for the prevention of AAD in an outpatient setting. A search of the PubMed database was conducted and yielded a total of 17 RCTs with 3631 participants to be included in the review. A meta-analysis was conducted for the primary outcome: the incidence of AAD. The pooled results found that AAD was present in 8.0% of the probiotic group compared to 17.7% in the control group (RR 0.49, 95% CI 0.36 to 0.66; I2 = 58%), and the species-specific results were similar regarding the probiotic strains L. rhamnosus GG and S. boulardii. However, the overall quality of the included studies was moderate. A meta-analysis of the ten trials reporting adverse events demonstrated no statistically significant differences in the incidence of adverse events between the intervention and control group (RD 0.00, 95% CI −0.02 to 0.02, 2.363 participants). The results suggests that probiotic use may be beneficial in the prevention of AAD among outpatients. Furthermore, the use of probiotics appears safe. View Full-Text
Keywords: primary care; antibiotic-associated diarrhea; probiotics; Lactobacillus; Bifidobacterium; Saccharomyces primary care; antibiotic-associated diarrhea; probiotics; Lactobacillus; Bifidobacterium; Saccharomyces
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Blaabjerg, S.; Artzi, D.M.; Aabenhus, R. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients—A Systematic Review and Meta-Analysis. Antibiotics 2017, 6, 21.

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