• Salmonella Typhimurium
• Wenchang chicken
• arachidonic acid
• gut microbiota
• lipid oxidation

• Metronidazole
• canine
• diarrhea
• hematochezia
• probiotics

• Dogs
• Humans
• Animals
• Metronidazole/therapeutic use
• Anti-Bacterial Agents/therapeutic use
• Diarrhea/drug therapy
• Diarrhea/veterinary
• Fluid Therapy/veterinary

• antibiotic-associated diarrhea
• bifidobacterium
• ords: lactobacillus
• prevention
• probiotic
• saccharomyces

Antibiotic-associated diarrhea (AAD) is diarrhea associated with consuming antibiotics that cannot be explained by other causes. AAD prolongs admission time and increases mortality and financial costs. Elderly individuals are more prone to receive antibiotic treatment and develop AAD. The finding that living probiotic microorganisms decrease AAD incidence in adults (<65 years) has been clarified. However, it is controversial among elderly individuals.

We aimed to explore whether probiotics could prevent AAD in elderly individuals. We searched three electronic databases (PubMed, EMBASE, and The Cochrane Library), and two reviewers independently screened and assessed the studies. RevMan5.4 software was used to perform a meta-analysis according to the PRISMA guidelines.

Eight RCTs of 4691 participants were included. We excluded two large studies because probiotics were used 48 hours after the first dose of antibiotics, and there was no effect. Subgroup analysis of 6 RCTs showed that probiotics given within two days of antibiotic treatment produced a lower AAD prevalence rate in elderly individuals.

We recommend that elderly individuals could be routinely distributed probiotics to prevent AAD development when receiving antibiotic treatment.

The review was not registered.

The online version contains supplementary material available at 10.1186/s12877-022-03257-3.

• Antibiotic-associated diarrhea
• Elderly
• Morbidity
• Probiotics

• Escherichia coli
• Lactobacillus
• intestinal health
• newly weaned pigs
• postbiotics

• Diarrhea prevention
• Gastrointestinal symptoms
• Hospital gastrointestinal symptoms
• Probiotic

• Anti-Bacterial Agents/therapeutic use
• Cross-Sectional Studies
• Humans
• Pediatrics/methods
• Pediatrics/trends
• Periodicals as Topic/statistics & numerical data
• Probiotics/therapeutic use
• Publishing/instrumentation
• Publishing/statistics & numerical data

• Adverse effects
• Alkalihalobacillus clausii
• Antibiotic-associated diarrhea
• Bristol stool scale
• Efficacy
• Time to last informed stool

• probiotics
• prevention
• antibiotic-associated diarrhea
• diarrhea
• adults

• Adult
• Anti-Bacterial Agents/adverse effects
• Diarrhea/chemically induced
• Diarrhea/prevention & control
• Humans
• Incidence
• Probiotics
• Randomized Controlled Trials as Topic
• Risk

Acute diarrhea in dogs is one of the most common reasons for veterinary visits. Although this disorder is generally self-limiting, antibiotics are still frequently used as treatment for acute diarrhea in clinical practice. Antimicrobial resistance represents a major challenge for public health and requires immediate and drastic solutions. To date, the emergence and spread of antimicrobial resistance has been attributed to the misuse or indiscriminate use of antibiotics. The aim of this study is to compare the effects on clinical activity and fecal microbiota of the administration of an antibiotic combination in comparison to a nutraceutical product in dogs with acute non-hemorrhagic diarrhea. The results of the present study suggest that this nutraceutical treatment had a similar clinical effect compared to the antibiotic formulation and may represent an alternative to commonly used antimicrobial therapy.

Dogs with acute diarrhea are often presented to clinical practice and, although this generally represents a self-limiting condition, antibiotics are still frequently used as treatment. The aim of this study was to evaluate the effects in dogs with acute non-hemorrhagic diarrhea of the administration of an antibiotic combination in comparison to a nutraceutical product. Thirty dogs were enrolled and randomly assigned to two groups: 15 dogs (group A) received a nutraceutical commercial product while 15 dogs (group B) received an antimicrobial combination of metronidazole and spiramycin. For each dog, the Canine Acute Diarrhea Severity Index, the fecal microbiota and the Dysbiosis Index were assessed. Both stool consistency and frequency decreased on day 2 in the dogs of group A compared to baseline, while in group B, these parameters significantly decreased at days 3 and 4. The global concern for rising antibiotic resistance associated with indiscriminate use of antimicrobials, in both humans and animals, suggests the necessity of avoiding empirical and injudicious use of these molecules in diarrheic dogs. These results suggest that the nutraceutical treatment had a similar clinical effect compared to the antibiotic formulation, representing a valid antibiotic-sparing therapeutic approach in canine acute diarrhea.

• Canine Acute Diarrhea Severity Index
• Dysbiosis Index
• acute diarrhea
• antibiotic-sparing therapy
• antimicrobial resistance
• dog
• gut microbiota
• nutraceutical

This study aimed to identify factors associated with antibiotic-associated diarrhea (AAD) in patients in the department of intensive care medicine who received antibiotic monotherapy in order to reduce the incidence of AAD and improve rational use of antibiotics in these patients.

To report the incidence of AAD and the factors associated with AAD in patients receiving antibiotic monotherapy.

The study used a single-center retrospective design. A total of 209 patients were enrolled. Patients were divided into two groups: No-AAD group (without AAD) and AAD group (with AAD). There were 45 cases in the AAD group and 164 cases in the no-AAD group. Clinical data of all patients were collected. Data were analyzed using SPSS (version 18.0), and statistical significance was set at P < 0.05.

The overall incidence of AAD was 21.53%. Age [odds ratio (OR) 1.022, 95% confidence interval (CI): 1.001-1.044, P = 0.040], proton pump inhibitor usage time (OR 1.129, 95%CI: 1.020-1.249, P = 0.019), antibiotic usage time (OR 1.163, 95%CI: 1.024-1.320, P = 0.020), and intensive care unit (ICU) stay time (OR 1.133, 95%CI: 1.041-1.234, P = 0.004) were associated with AAD in ICU patients receiving antibiotic monotherapy. mean ± SD ICU stay time was lower in the no-AAD group (8.49 ± 6.31 vs 15.89 ± 10.69, P < 0.001). However, there was no significant difference in ICU-related mortality rates between the two groups (P = 0.729).

Older age, longer ICU stay time, duration of use of proton pump inhibitors, and duration of antibiotic increase the incidence of AAD in ICU patients receiving antibiotic monotherapy.

• Diarrhea
• Intensive care unit
• Critically ill
• Mortality
• Antibiotics
• Monotherapy

• Abdominal pain
• Anti-bacterial agents
• Antibiotic-associated diarrhea
• Children
• Constipation
• Diarrhea
• Lactobacillus reuteri
• Lactobacillus rhamnosus GG
• Probiotics

• acute diarrhea
• chronic diarrhea
• stress diarrhea
• synbiotic

• Animals
• Diarrhea/prevention & control
• Dog Diseases/prevention & control
• Dogs
• Gastrointestinal Diseases/prevention & control
• Gastrointestinal Diseases/veterinary
• Probiotics

• Gold nanoparticles
• Lactobacillus rhamnosus
• Rhodamine 6G
• Surface-enhanced Raman spectroscopy

Background: The widespread use of antibiotics has resulted in a high incidence of antibiotic-associated diarrhea (AAD); moreover, the AAD-associated mortality rates have also increased. The effect of combined antibiotic administration on AAD in critically ill patients was analyzed to assist in antibiotic selection for AAD prevention.

Methods: Clinical data of patients hospitalized were retrospectively analyzed. Patients were either assigned to the combined-use group (CG) or the monotherapy group (MG). Age, sex, albumin levels, proton pump inhibitors, the type antibiotics, occurrence of AAD were collected. All relevant data were analyzed using SPSS version 18.0 (IBM Inc., Armonk, NY, USA), and significance was set at P<0.05.

Measurements and main results: Overall, 277 patients were enrolled (CG, n=143; MG, n=134). The incidence of AAD was significantly different between the groups (44.06% vs 17.16%, P<0.001). Combined use of three or more antibiotics, other antibiotics combined with antifungals antibiotics increases the incidence of AAD (P<0.05). Duration of proton pump inhibitor therapy (odds ratio [OR] 1.142, 95% confidence interval [CI] 1.048–1.244, P=0.002), antifungal antibiotic administration (OR 3.189, 95% CI 1.314–7.740, P=0.010), and beta-lactam plus enzyme inhibitor antibiotic administration (OR 3.072, 95% CI 1.309–7.205, P=0.010) were associated with AAD in critically ill patients receiving combined antibiotics therapy. The mean duration of intensive care unit admission was longer among patients with AAD compared with patients without AAD (19.70±12.16 vs 12.29±8.06 days, P<0.001), with no significant difference in intensive care unit-related mortality rates.

Conclusion: Combined administration of antibiotics, especially beta-lactam plus enzyme inhibitors and antifungals, may increase the incidence of AAD in critically ill patients.

• antibiotics
• diarrhea
• intensive care units
• pseudomembranous colitis

To analyze factors related to antibiotic-associated diarrhea (AAD) in patients in the intensive care unit (ICU) receiving antifungals with the aim of informing rational antibiotic use.

Sex, age, medical history, use of proton pump inhibitors, administration of parenteral nutrition, albumin level, occurrence of AAD, type of antibiotics, duration of ICU admission, and prognosis were retrospectively analyzed. The associations of age, sex, medical history, and other factors with AAD were associated by logistic regression.

In total, 284 patients were enrolled (antifungals, n = 110; no antifungals, n = 174). The total incidence of AAD was 32.39%. The incidence of AAD was significantly different between the groups (52.73% vs. 19.54%). The duration of proton pump inhibitor therapy, duration of antifungal therapy, enzyme inhibitor antibiotic use, and azithromycin use were associated with AAD in ICU patients receiving antifungal therapy. The mean duration of ICU admission was higher in patients receiving antifungal therapy (20.14 ± 11.50 vs. 14.48 ± 8.54 days). There was no significant difference in ICU mortality rates.

The duration of proton pump inhibitor therapy, duration of antifungal therapy, use of enzyme inhibitor antibiotics, and use of azithromycins were associated with AAD in ICU patients receiving antifungal therapy.

• Diarrhea
• antibiotics
• antifungals
• azithromycins
• enzyme inhibitors
• intensive care unit
• proton pump inhibitors

• Antibiotics
• Children
• Diarrhea
• Hypospadias
• Placebo
• Probiotics

Very few reports have been published to date on the bloodstream infections caused by Saccharomyces spp. in oncohaematological patients, and there are no guidelines on the use of this probiotic microorganism in this population. We describe the use of probiotic preparation containing Saccharomyces boulardii in a large group of oncohaematological patients. We retrospectively analysed the data from 32,000 patient hospitalisations at the haematological centre during 2011–2013 (including 196 haematopoietic stem cell transplant recipients) in a tertiary care university-affiliated hospital. During the study period, 2270 doses of Saccharomyces boulardii probiotic were administered to the oncohaematological patients. In total, 2816 mycological cultures were performed, out of which 772 (27.4%) were positive, with 52 indicating digestive tract colonisation by Saccharomyces spp., mainly in patients with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS) or multiple myeloma (MM). While colonised, they were hospitalised for 1683 days and 416 microbiological cultures of their clinical samples were performed. In the studied group of patients, there were six blood cultures positive for fungi; however, they comprised Candida species: two C. glabrata, one C. albicans, one C. krusei, one C. tropicalis and one C. parapsilosis. There was no blood culture positive for Saccharomyces spp. Our study indicates that despite colonisation of many oncohaematological patients with Saccharomyces spp., there were no cases of fungal sepsis caused by this species.

• Haematology
• Leukaemia
• Lymphoma
• Probiotic
• Saccharomyces boulardii

• Antibiotic-associated diarrhea (AAD)
• Antibiotics
• Meta-analysis
• Probiotics

• Anti-Bacterial Agents/adverse effects
• Diarrhea/chemically induced
• Diarrhea/prevention & control
• Humans
• Probiotics/therapeutic use

• antifungal agents
• clostridium difficile
• diarrhea
• enterocolitis, pseudomembranous

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents/adverse effects
• China/epidemiology
• Critical Illness
• Diarrhea/chemically induced
• Diarrhea/epidemiology
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Parenteral Nutrition
• Probiotics
• Retrospective Studies
• Risk Factors

Antibiotic-associated gastrointestinal signs (AAGS) occur commonly in cats. Co-administration of synbiotics is associated with decreased AAGS in people, potentially due to stabilization of the fecal microbiome and metabolome. The purpose of this double-blinded randomized-controlled trial was to compare AAGS and the fecal microbiome and metabolome between healthy cats that received clindamycin with a placebo or synbiotic.

16 healthy domestic shorthair cats from a research colony were randomized to receive 150 mg clindamycin with either a placebo (eight cats) or commercially-available synbiotic (eight cats) once daily for 21 days with reevaluation 603 days thereafter. All cats ate the same diet. Food consumption, vomiting, and fecal score were recorded. Fecal samples were collected daily on the last three days of baseline (days 5–7), treatment (26–28), and recovery (631–633). Sequencing of 16S rRNA genes and gas chromatography time-of-flight mass spectrometry was performed. Clinical signs, alpha and beta diversity metrics, dysbiosis indices, proportions of bacteria groups, and metabolite profiles were compared between treatment groups using repeated measures ANOVAs. Fecal metabolite pathway analysis was performed. P < 0.05 was considered significant. The Benjamini & Hochberg’s False Discovery Rate was used to adjust for multiple comparisons.

Median age was six and five years, respectively, for cats in the placebo and synbiotic groups. Hyporexia, vomiting, diarrhea, or some combination therein were induced in all cats. Though vomiting was less in cats receiving a synbiotic, the difference was not statistically significant. Bacterial diversity decreased significantly on days 26–28 in both treatment groups. Decreases in Actinobacteria (Bifidobacterium, Collinsella, Slackia), Bacteriodetes (Bacteroides), Lachnospiraceae (Blautia, Coprococcus, Roseburia), Ruminococcaceae (Faecilobacterium, Ruminococcus), and Erysipelotrichaceae (Bulleidia, [Eubacterium]) and increases in Clostridiaceae (Clostridium) and Proteobacteria (Aeromonadales, Enterobacteriaceae) occurred in both treatment groups, with incomplete normalization by days 631–633. Derangements in short-chain fatty acid, bile acid, indole, sphingolipid, benzoic acid, cinnaminic acid, and polyamine profiles also occurred, some of which persisted through the terminal sampling timepoint and differed between treatment groups.

Cats administered clindamycin commonly develop AAGS, as well as short- and long-term dysbiosis and alterations in fecal metabolites. Despite a lack of differences in clinical signs between treatment groups, significant differences in their fecal metabolomic profiles were identified. Further investigation is warranted to determine whether antibiotic-induced dysbiosis is associated with an increased risk of future AAGS or metabolic diseases in cats and whether synbiotic administration ameliorates this risk.

• Antibiotic-associated diarrhea
• Antibiotic-associated gastrointestinal signs
• Bile acids
• Dysbiosis
• Indole
• Metabolome
• Polyamines
• Probiotic
• Short-chain fatty acids
• Sphingolipids

• Antibiotic
• Clostridium difficile
• Diarrhea
• Probiotics
• Spores
• Vancomycin

• Clostridium difficile infection
• Probiotic
• antibiotic-associated diarrhea
• network meta-analysis

Synbiotics often are prescribed to limit antibiotic‐associated gastrointestinal signs (AAGS) in cats, but data to support this recommendation are lacking.

To determine whether synbiotic co‐administration mitigates AAGS in healthy research cats treated with clindamycin.

16 healthy research cats.

A randomized, double‐blinded, placebo‐controlled, 2‐way, 2‐period, crossover study with a 6‐week washout was performed. Each study period consisted of a 1‐week baseline and a 3‐week treatment period. Cats received 75 mg clindamycin with food once daily for 3 weeks, followed 1 hour later by either 2 capsules of a synbiotic or placebo. Food consumption, vomiting, fecal score, and completion of treatment were compared using repeated measures split plot or crossover designs with covariates, with P < 0.05 considered significant.

Cats that received the synbiotic were more likely to complete treatment in period 1 (100% vs. 50%, P = 0.04). Cats vomited less when receiving the synbiotic but this was not significant, but there were significant period effects (F‐value = 11.4, P < 0.01). Cats had higher food intake while receiving the synbiotic (F‐value = 31.1, P < 0.01) despite period effects (F‐value = 8.6, P < 0.01). There was no significant effect of treatment on fecal scores, which significantly increased over time (F‐value = 17.9, P < 0.01).

Administration of a synbiotic 1 hour after clindamycin administration decreased hyporexia and vomiting in healthy cats. Additionally, significant period effects suggest that clinical benefits of synbiotic administration persist for at least 6 weeks after discontinuation, decreasing the severity of AAGS in cats that subsequently received clindamycin with placebo. Unlike in people, synbiotic administration did not decrease antibiotic‐associated diarrhea.

• Antibiotic-associated diarrhea
• Antibiotic-associated gastrointestinal signs
• Diarrhea and vomiting
• Probiotic

• alternative
• antibiotic
• complementary
• microbiome

• Adultos
• Adults
• Children
• Consenso
• Consensus
• Enfermedades gastrointestinales
• Gastrointestinal diseases
• Mexico
• México
• Niños
• Probiotics
• Probióticos

• Adult
• Child
• Consensus
• Delphi Technique
• Gastroenterology
• Guidelines as Topic
• Humans
• Mexico
• Probiotics/therapeutic use

• Bifidobacterium lactis
• digestive symptoms
• gastrointestinal discomfort
• meta-analysis
• probiotic
• systematic review

• Fungal infection
• Fungemia
• Probiotic
• Saccharomyces boulardii
• Strain typing

This randomized, open-label study evaluated the additional benefits of the synbiotic Prodefen® in the clinical management of acute diarrhea of suspected viral origin in children between 6 months and 12 years of age. Study outcomes included the duration of diarrhea, the recovery from diarrhea, and the tolerability and acceptance of the treatment. The proportion of patients without diarrhea over the study period was greater in the synbiotic group than in the control group at all study time points, showing a statistically significant difference on the fifth day (95% vs 79%, p < 0.001). The duration of diarrhea (median and interquartile range) was reduced by 1 day in the synbiotic-treated patients (3 [2-5] vs 4 [3-5], p = 0.377). The tolerability of the treatment regimen, as evaluated by the parents, was significantly better in those receiving the synbiotic than in the control group. Overall, 96% of the parents of children receiving the synbiotic reported being satisfied to very satisfied with the treatment regimen. The results of this study indicate that the addition of the synbiotic Prodefen® is a well-tolerated and well-accepted approach that provides an additional benefit to the standard supportive therapy in the management of acute viral diarrhea in children.

• Prodefen
• acute diarrhea
• children
• efficacy
• probiotic
• synbiotic
• tolerability

For decades, treatment of infectious diseases has been a strong focus of interest, for both researchers and healthcare providers. Chronic infection with Helicobacter pylori (H. pylori) has been reported to be associated with several diseases, such as ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Infection with H. pylori is generally acquired during childhood and can persist indefinitely, if not treated systematically. Unfortunately, although several strategies have shown high efficacy results, treatment of the H. pylori infection fails in about 25%–30% of infected children. One main reason for this is due to the extensive use of antibiotics, which has created antibiotic resistance, associated with other adverse effects as well. Therefore, it is crucial to find alternative strategies to combat this resistance, and increase treatment efficacy results. Probiotics, which are live microorganisms that are orally administrated, have been found to be a useful regimen in the treatment of the H. pylori infection in children. Their use as a dietary supplement alone, or in combination with antibiotics, resulted in reduced side effects and higher efficacy rates of the H. pylori infection in children. Some probiotics can be considered an adjunctive treatment, especially when eradication of the H. pylori infection fails during initial treatment, and to help reduce adverse effects. However, the evidence of the beneficial role of probiotics is limited due to the small number of clinical trials that have been conducted and heterogeneity across studies in strains and dosage. Additionally, no investigations have been carried out in asymptomatic children. Therefore, large well-conducted studies are needed to evaluate the efficacy and safety of probiotics as an adjuvant therapy of the H. pylori infection.

• Helicobacter pylori infection
• children
• dietary supplements
• eradication treatment
• probiotics

• Allergy
• Diarrhea
• IBD
• IBS
• Necrotising enterocolitis

• Bio-K+
• Clostridium difficile
• Fecal microbiota transplantation
• Lactobacillus
• Lifeway kefir
• Probiotic

• Anti-Bacterial Agents/adverse effects
• Anti-Bacterial Agents/pharmacology
• Anti-Bacterial Agents/therapeutic use
• Bacterial Infections/drug therapy
• Bacterial Infections/microbiology
• Disease Susceptibility
• Host-Pathogen Interactions/drug effects
• Humans
• Metagenome
• Metagenomics
• Microbiota/drug effects
• Risk Factors

• DP2 DK098089 NIDDK NIH HHS
• R01 GM099538 NIGMS NIH HHS
• T32 DK077653 NIDDK NIH HHS
• DP2-DK-098089 NIDDK NIH HHS
• R01-GM099538 NIGMS NIH HHS
• UL1 TR000448 NCATS NIH HHS
• TL1 TR000449 NCATS NIH HHS
• National Institutes of Health
• National Center for Advancing Translational Sciences
• National Institute of General Medical Sciences

• Formula
• Gastroenteritis
• Infants
• NEC
• Prebiotics
• Probiotics