Effectiveness of Lactobacillus helveticus and Lactobacillus rhamnosus for the management of antibiotic-associated diarrhoea in healthy adults: a randomised, double-blind, placebo-controlled trial

Br J Nutr. 2016 Jul;116(1):94-103. doi: 10.1017/S0007114516001665. Epub 2016 May 12.

Abstract

Broad-spectrum antibiotic use can disrupt the gastrointestinal microbiota resulting in diarrhoea. Probiotics may be beneficial in managing this type of diarrhoea. The aim of this 10-week randomised, double-blind, placebo-controlled, parallel study was to investigate the effect of Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011 supplementation on antibiotic-associated diarrhoea in healthy adults. Subjects were randomised to receive 1 week of amoxicillin-clavulanic acid (875 mg/125 mg) once per day, plus a daily dose of 8×109 colony-forming units of a multi-strain probiotic (n 80) or placebo (n 80). The probiotic or placebo intervention was maintained for 1 week after completion of the antibiotic. Primary study outcomes of consistency and frequency of bowel movements were not significantly different between the probiotic and placebo groups. The secondary outcomes of diarrhoea-like defecations, Gastrointestinal Symptoms Rating Scale scores, safety parameters and adverse events were not significantly different between the probiotic intervention and the placebo. A post hoc analysis on the duration of diarrhoea-like defecations showed that probiotic intervention reduced the length of these events by 1 full day (probiotic, 2·70 (sem 0·36) d; placebo, 3·71 (sem 0·36) d; P=0·037; effect size=0·52). In conclusion, this study provides novel evidence that L. helveticus R0052 and L. rhamnosus R0011 supplementation significantly reduced the duration of diarrhoea-like defecations in healthy adults receiving antibiotics.

Keywords: AAD antibiotic-associated diarrhoea; Antibiotic-associated diarrhoea; BSS Bristol Stool Scale; CFU colony-forming units; DBHD daily bowel habits diary; DLD diarrhoea-like defecations; Diarrhoea-like defecation; GSRS Gastrointestinal Symptom Rating Scale; Lactobacillus helveticus; Lactobacillus rhamnosus; Probiotics.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amoxicillin-Potassium Clavulanate Combination / adverse effects*
  • Anti-Bacterial Agents / adverse effects*
  • Diarrhea / chemically induced*
  • Diarrhea / microbiology
  • Double-Blind Method
  • Humans
  • Lactobacillus helveticus*
  • Lactobacillus rhamnosus*
  • Probiotics / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Amoxicillin-Potassium Clavulanate Combination