I just got out of the hospital for cellulitis where I was treated with IV antibiotics. My discharges notes said “take antibiotics to prevent diarrhea”. I asked which ones… blank faces. No one seem to have a concrete idea. So this is a review of the literature:
- “Antibiotic-associated diarrhea (AAD) occurs in approximately 25% of patients receiving antibiotics.” [2008]
- ” analyzing 25 randomized controlled trials of probiotics for the prevention of AAD … more than half of the trials demonstrated efficacy of the probiotic. ” So a random probiotic may have just a 50% chance of being effective. [2008]
- “We identified no evidence that a multistrain preparation of lactobacilli and bifidobacteria was effective in prevention of AAD or CDD. ” [2013]
- Bacillus subtilis and Enterococcus faecium (A Retrospective Study of Probiotics for the Treatment of Children With Antibiotic-Associated Diarrhea [2020])
- Lactobacillus casei DN 11400 (Commercially Available Probiotic Drinks Containing Lactobacillus Casei DN-114001 Reduce Antibiotic-Associated Diarrhea, 2014) i.e. Yakult drink
- Lactobacillus GG (culturelle), Bacillus coagulans, and S. boulardii appeared to be most effective [2008]
If you find any other studies that is explicit on the probiotic strains used with good results, please email me at Ken/at\lassesen.com
To help find which probiotics contain the above see this page.
If diarrhea occurs while on fluoroquinolone prophylaxis, the only remaining option is AZM. Additionally, fluoroquinolone prophylaxis, and antibiotic use in general, may have unintended consequences such as selection for antibiotic resistant gut flora 9 , 56 or disruption of the gut microbiome that could lead to colonization with pathogenic bacteria such as Clostridium difficile. 57 However, there are two problems with rifaximin prophylaxis.
Other options for diarrhea are here (with supporting studies)
https://microbiomeprescription.com/Library/ProbioticSearch?term=diarrhea