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Consuming supplements and food containing probiotics may reduce the risk of antibiotic-associated diarrhea, according to a systematic review from the prestigious Cochrane Collaboration. Get FREE access to authoritative breaking news, videos, podcasts, webinars and white papers. We are constantly being assaulted by environmental pollutants and toxins such as UV rays, diesel exhaust and cigarette smoke. Conducting a clinical trial in the health nutrition industry can be an intimidating process. Bergstrom Nutrition pioneered the use of MSM for human health and remains the industry’s leading manufacturer of MSM. INNOBIO is a leading manufacturer of functional nutritional ingredients and an expert in meeting customer specific requirements.
At the end of May, a new Cochrane review was published, which looked at the evidence for probiotic treatment in the prevention of antibiotic-associated diarrhoea, which is often caused by Clostridium difficile; this meta-analysis found that whilst antibiotic-associated diarrhoea (AAD) was reduced by probiotic treatment, C.
In this systematic review, a total of 31 randomised controlled trials were included, and for each outcome measure assessed, the authors assessed the possibility of bias for each measure included in each trial.
The meta-analysis also looked at adverse events, as well as C. difficile infection rates (including all infections, not just those leading to diarrhoea).
Meta-analysis is not just about pooling data, but also about looking at the quality and completeness of the evidence available, as alluded to with the discussion of bias estimates above. TwitterWe're still looking for students to blog as part of a new series on 'understanding claims made about treatments'. A systemic review by Cochrane researchers has confirmed the use of probiotics as a safe and effective measure in the treatment of acute infectious diarrhoea. Data reviewed from 63 trials involving a total of 8014 patients revealed that probiotic therapy significantly reduced both the duration and severity of diarrhoea, and was not associated with adverse side-effects. Probiotics investigated in the trials included a range of Lactobacillus and Bifidobacterium strains plus Sachharomyces boulardii.


These review findings validate the use of combined Lactobacillus, Bifidobacterium and Saccharomyces boulardii in the treatment of both short and long term diarrhoea in infants and children.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. However, we still need to establish the probiotic strains and doses that provide the best results, and determine the safety of probiotics in immunocompromised patients.”The issueAntibiotics treatment is known to disturb the beneficial bacteria that live in the gut, and it may allow other harmful bacteria like C.
Probiotics taken in conjunction with antibiotics reduced the number of people who suffered diarrhoea by 64%. Using a Forest plot (Like the one in the Cochrane logo, explained in detail here [3]), they pooled the results from these studies to find the overall effect of treatment versus control; in this case, the results favoured the treatment, as those given probiotics were at lower risk of AAD. In terms of adverse events, a lower risk of an event was seen in the probiotic group compared to the control. Here, funnel plots come in handy, for looking at both publication bias, and the possible effect of future studies on the effect estimate.
A walk through a systematic review by Alice Buchan is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Both acute and persistent diarrhoea rapidly results in dehydration and leads to frequent intestinal discomfort, compromised uptake of micro- and macro-nutrients, sleep disruptions and reduced weight gain.
Probiotics work to rebalance the intestinal ecosystem, thereby reducing numbers of pathogenic microorganisms.
Current maintenance treatments have multiple adverse events and an effective treatment with minimal adverse events is desired.
Given that AAD is both common, and potentially severe (pseudomembranous colitis that develops into toxic megacolon can be life-threatening [2]), its prevention could have a significant impact on patient care and outcomes. Interestingly, there was no statistically significant reduction in C. difficile infection rates in this group. For a discussion of the interpretation of funnel plots with respect to publication bias, see here [4].


However, as noted by the authors, the total number of patients included in the analysis is still relatively small; in addition to bias in studies, lack of reporting of adverse effects, and other factors, the quality of the evidence for the outcome measures examined is considered moderate or low (See here for a resource about grading evidence). They regulate the local immune system via enhanced secretory immunoglobulin A (sIgA) release and attenuate pathogen binding to the intestinal wall. Several studies have demonstrated the importance of intestinal flora in the pathogenesis of ulcerative colitis. As well as being of clinical significance, this review also provides a great example to look at the way Cochrane reviews are conducted, and some of the statistical graphs commonly used in meta-analyses, especially if you are new to reading them.
They reduce intestinal permeability, suppress local inflammation, and inhibit toxins produced by pathogens (e.g. It has been suggested that modifying the bacterial flora with probiotics may attenuate the inflammatory process and prevent relapses in ulcerative colitis. Our previous Cochrane review of the evidence in this area found only four studies and no evidence regarding the efficacy of probiotics, but much work has been published in recent years. This allows other causes of asymmetry (other than publication bias) to be ruled out, and also allows the examination of whether the predicted effect size is robust to future studies.
Moreover, probiotics improve fermentation and digestion of carbohydrates, hence relieving diarrhoea, bloating and other symptoms associated with specific food intolerances. An up to date Cochrane systematic review was performed to determine the efficacy and safety of probiotics for the maintenance of remission in ulcerative colitis.
Essentially, it shows the area on the plot into which a future study would have to fall in order for the effect estimate generated to no longer be of statistical significance compared to the control.



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