Intake of Lactobacillus plantarum reduces certain gastrointestinal symptoms during treatment with antibiotics.
OBJECTIVE
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.


METHODS
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.
Lönnermark
Elisabet
E
Department of Clinical, Gothenburg University, Göteborg, Lund, Sweden. elisabet.lonnermark@infect.gu.se
Friman
Vanda
V
Lappas
Georg
G
Sandberg
Torsten
T
Berggren
Anna
A
Adlerberth
Ingegerd
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000382:microbiology / Q000517:prevention & control; D003967:Diarrhea / Q000139:chemically induced / Q000382:microbiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006785:Hospitals, University; D006801:Humans; D048191:Lactiplantibacillus plantarum; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents