Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis

Henry Wanyama; Tayyab S Akhtar; Sameen Abbas

doi:10.5114/pg.2025.148486

Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis

Prz Gastroenterol. 2025;20(1):5-16. doi: 10.5114/pg.2025.148486. Epub 2025 Mar 16.

Authors

Henry Wanyama¹, Tayyab S Akhtar², Sameen Abbas³

Affiliations

¹ Department of Internal Medicine, Moi Teaching and Referral Hospital, Kenya University of South Wales, Cardiff, United Kingdom.
² University of South Wales, Cardiff, United Kingdom Center for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi, Pakistan.
³ Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan.

Abstract

Introduction: Probiotics potentially mitigate diarrhea incidence and severity, but their effectiveness in antibiotic-associated diarrhea (AAD) remains debated.

Aim: This meta-analysis aimed to enhance evidence on probiotic use for AAD.Methods: A systematic search of randomized controlled trials (RCTs) from 2010 to 2023 in PubMed, EMBASE, Scopus, and Google Scholar was conducted. Eligible studies underwent risk assessment with the RoB-2 tool and data extraction using the random effects model. Subgroup analyses evaluated age, sample size, and probiotic strains' influence.

Results: Fifteen trials with 7427 participants were included. Overall quality was moderate. Pooled analysis favored probiotics, reducing AAD incidence by 40% (RR = 0.60, 95% CI: 0.43-0.82). This effect was consistent across subgroup analyses. Multistrain probiotics showed superior protection (RR = 0.40 vs. 0.9 or 0.6 for dual or single strains).

Conclusions: This review suggests that probiotics, especially multistrain combinations, mitigate AAD incidence. Future large-scale RCTs will address heterogeneity.

Keywords: antibiotic-associated diarrhea; incidence; meta-analysis; probiotics.

Publication types

Review