Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea

摘要: Context Probiotics are live microorganisms intended to confer a health benefit when consumed. One condition for which probiotics have been advocated is the diarrhea that common adverse effect of antibiotic use. Objective To evaluate evidence probiotic use in prevention and treatment antibiotic-associated (AAD). Data Sources Twelve electronic databases were searched (DARE, Cochrane Library Systematic Reviews, CENTRAL, PubMed, EMBASE, CINAHL, AMED, MANTIS, TOXLINE, ToxFILE, NTIS, AGRICOLA) references included studies reviews screened from database inception February 2012, without language restriction. Study Selection Two independent reviewers identified parallel randomized controlled trials (RCTs) (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus) or AAD. Extraction extracted data assessed trial quality. Results A total 82 RCTs met inclusion criteria. The majority used Lactobacillus -based interventions alone combination with other genera; strains poorly documented. pooled relative risk DerSimonian-Laird random-effects meta-analysis 63 RCTs, 11 811 participants, indicated statistically significant association administration reduction AAD (relative risk, 0.58; 95% CI, 0.50 0.68; P  2 , 54%; [risk difference, −0.07; −0.10 −0.05], [number needed treat, 13; 10.3 19.1]) reporting on number patients This result was relatively insensitive numerous subgroup analyses. However, there exists heterogeneity results insufficient determine whether this varies systematically by population, characteristic, preparation. Conclusions suggests associated More research greatest efficacy receiving specific antibiotics.