Antibiotics are widely used in residential aged care facilities to treat a variety of infections. One of the side effects of these medications is diarrhoea.
Probiotics have been found to assist in the control of antibiotic diarrhoea.
Antibiotic Associated Diarrhoea (AAD) is diarrhoea that occurs when taking antibiotics that can’t be explained by any other cause.
The World Health Organisation defines diarrhoea as the passage of 3 or more loose or liquid stools per day.
Between 5-70% of adults who use antibiotics will experience diarrhoea with those using broad spectrum antibiotics at higher risk for AAD.
Older adults are more prone to AAD due to their age, frequent hospitalisations, extensive use of antibiotics, changes in gut mucosa, intestinal flora and multiple co-morbidities.
AAD can increase hospital admission times, increase mortality, and reduce quality of life.
Strategies for managing AAD include inclusion of probiotics into the diet daily.
Probiotics are ‘live microorganisms which, when administered in adequate amounts, confer a health benefit on the host’
(Food and Agriculture Organization (FAO) and World Health Organization (WHO), 2002)
The exact mechanism of how probiotics help manage AAD is unknown, but it is believed that probiotics can help prevent and treat diarrhoea by:
It is important to note that not all probiotics are created equal. For probiotics to be effective in AAD the CORRECT strain given at the recommended DOSE and DURATION is needed.
9 Probiotic strains have been shown to assist with managing AAD in well-designed clinical trials. These strains include:
-Saccharomyces Boulardii - Lactobacillus acidophilus -Lactobacillus bulgaricus
- Lactobacillus rhamnosus - Lactobacillus bifidum - Lactobacillus longum
- Lactobacillus casei -Streptococcus thermophilus -Clostridium butyricum
Research has shown that probiotics should be taken when antibiotics are commenced or within a few days of commencing antibiotics. Most manufacturers recommended taking antibiotics and probiotics at least 2 hours apart.
It is also recommended that probiotics be taken at least 1 week after antibiotics cessation with some studies recommending probiotics be continued for up to 4 weeks after antibiotics have been ceased.
A systematic and Meta-analysis into probiotics found that probiotics can reduce the risk of antibiotic-associated diarrhea by up to 51%.
Please contact the Food Solutions Dietetics team for guidance on how to effectively use probiotics in managing AAD.
Lim, L and Bennett, N. (2022). Improving management of urinary tract infections residential aged care facilities. Australian Journal of General Practice, V 51:8:551-557.
Zhang, L Feng, X, Guo, D, Zou, Yupei, G, H and H, X,. (2022). Early use of probiotics might prevent antibiotic-associated diarrhoea in elderly ( >65 years): A systematic review and Meta-analysis. BMC Geriatr. 22:562
Gergussion, JR and Taylor, K. (2022). Probiotics for Antibiotic-Associated Diarrhoea: What, When, and How Long? International Journal of Clinical Medicine. 13:571-583
