the use of probiotics to prevent antibiotic complications

Since Fleming discovered the anti bacterial activity of penicillin, a range of antibiotics have been discovered. An important source of antibiotics has been from soil micro organisms These have varied in their usefulness and toxic properties. Bearing in mind that their original role was to protect themselves in the soil environment which is a free for all. Some micro organisms produce herbicides as well as antibiotics.
Quinn JP2007, Unchartered route for antibiotics Nature 448, 415-416
When used in clinical care in man diarrhoea is a common side effect which can have a considerable impact on a person already enfeebled by an infection. Clostridia difficile is a common cause of the diarrhoea.
Normally there is a protective coat of micro organisms on the mucosa of the intestine and colon. When a really effective antibiotic arrives this protection is lost and Clostridia difficile takes over, along with a brisk diarrhoea. .
The method of preventing this complication would be to replace the depleted bacteria with sympathetic microorganisms using pro biotics which are a living beneficial bacteria or yeasts that are taken orally to restore the microbial balance. There are many pro biotic preparations on the market. They have a long history dating from the 19th century. The revival of yoghurt as a cure all dates from that time.
In a trial of various probiotics taken at the same time as the antibiotic, those who took the probiotics did not become colonised with Clostridia difficile whereas the placebo group were less fortunate ( 17% ) . However the numbers were small and recruited over a long period of time.
Probiotics are poorly designated , but are a harmless addition to care and even nice to take.
McFarland LV 2007. Diarrhoea associated with antibiotic use. BMJ; 335: 54
Hickson M et al . Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo trial . BMJ , 335: 80-3

Martin Eastwood
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