Feature Review: Probiotics for the prevention antibiotic-associated diarrhea in children

Should kids taking antibiotics also take probiotics?

Should kids taking antibiotics also take probiotics?

Antibiotic-associated diarrhea (AAD) occurs when antibiotics disturb the natural balance of "good" and "bad" bacteria in the intestinal tract, causing harmful bacteria to multiply beyond their normal numbers. The symptoms of AAD include frequent watery bowel movements and crampy abdominal pain. Probiotics are found in dietary supplements or yogurts and contain potentially beneficial bacteria or yeast. Probiotics may restore the natural balance of bacteria in the intestinal tract and prevent AAD.


A team of Cochrane authors based in Canada and the United States worked with the Cochrane IBD group to investigate whether probiotics prevent AAD in children receiving antibiotic therapy and whether probiotics causes any side effects. Twenty-three studies were included, with a total of 3,938 children, ranging from 2 weeks to 17 years of age, who were receiving probiotics co-administered with antibiotics to prevent AAD. The evidence was rated to be of moderate quality. 


Analyses showed that probiotics may be effective for preventing AAD in children. The incidence of AAD in the probiotic group was 8% (163/1992) compared to 19% (364/1906) in the control group. Probiotics were generally well tolerated, and minor side effects occurred infrequently, with no significant difference between probiotic and control groups. Among the various probiotics evaluated, Lactobacillus rhamnosus or Saccharomyces boulardii at a dosage of 5 to 40 billion colony forming units per day may be appropriate for preventing AAD in children receiving antibiotics. Until further research has been conducted, probiotic use should be avoided in pediatric populations at risk for side effects including severely debilitated or immuno-compromised children.


“Diarrhea in children taking antibiotics is a concern to parents. Our Cochrane Review looked at the results of 23 studies and found probiotics to be effective for preventing diarrhea that is brought on by antibiotics in children,” said Joshua Goldenberg, the lead author of the Cochrane Review.


Read the full Cochrane Review

Visit the Cochrane IBD website


Thursday, January 14, 2016