Probiotics in the prevention of antibiotic-associated diarrhea in children: a meta-analysis of randomized controlled trials

J Pediatr. 2006 Sep;149(3):367-372. doi: 10.1016/j.jpeds.2006.04.053.


Objective: To systematically evaluate the effectiveness of probiotics in preventing antibiotic-associated diarrhea (AAD) in children.

Study design: The following electronic databases up to December 2005, in any language, were searched for studies relevant to AAD and probiotics: MEDLINE, EMBASE, and The Cochrane Library. Only randomized controlled trials (RCT) were considered for study inclusion.

Results: Six placebo-controlled, RCTs (766 children) were included. Treatment with probiotics compared with placebo reduced the risk of AAD from 28.5% to 11.9% (relative risk, RR, 0.44, 95% CI 0.25 to 0.77, random effect model). Preplanned subgroup analysis showed that reduction of the risk of AAD was associated with the use of Lactobacillus GG (2 RCTs, 307 participants, RR 0.3, 95% CI 0.15 to 0.6), S. boulardii (1 RCT, 246 participants, RR 0.2, 95% CI 0.07-0.6), or B. lactis & Str. thermophilus (1 RCT, 157 participants, RR 0.5, 95% CI 0.3 to 0.95).

Conclusions: Probiotics reduce the risk of AAD in children. For every 7 patients that would develop diarrhea while being treated with antibiotics, one fewer will develop AAD if also receiving probiotics.

Publication types

  • Meta-Analysis

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Bacillus
  • Child
  • Diarrhea / chemically induced*
  • Diarrhea / prevention & control*
  • Humans
  • Lactobacillus
  • Probiotics / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Saccharomyces
  • Streptococcus thermophilus
  • Treatment Outcome


  • Anti-Bacterial Agents