Lactobacillus reuteri for the prevention of AAD in hospitalised adults

A randomised, double blind, placebo-controlled pilot trial studying the effects of Lactobacillus reuteri ATCC 55730 on the incidence of diarrhoea in hospitalised adults treated with different antibiotics.

The intake of Lactobacillus reuteri significantly decreased the incidence of antibiotic-associated diarrhoea in hospitalised adults

The patients ingested either Lactobacillus reuteri 2×10^8 CFU (one tablet twice daily, n=13) or an identical placebo (n=10) for 4 weeks. Pneumonia, abscess, chronic obstructive pulmonary disease and bronchitis were the most common diagnoses that required antibiotic treatment. Stool frequency, consistency and gastrointestinal symptoms were monitored during the 4 weeks and for a further 2 weeks after the supplementation was stopped.

The patients given Lactobacillus reuteri had a significantly lower incidence of diarrhoea compared to those given placebo: 7.7% in the probiotic group vs. 50.0% in the placebo group (p=0.02). There were no differences in the incidence or severity of nausea, vomiting, abdominal cramping, bloating, gas, constipation
or reflux.

Conclusion: The intake of Lactobacillus reuteri significantly decreased the incidence of antibiotic-associated diarrhoea in hospitalised adults, and Lactobacillus reuteri was well tolerated.

Lactobacillus reuteri and side-effects during Helicobacter pylori treatment

A double blind, randomised and placebo-controlled study investigating the effect of Lactobacillus reuteri ATCC 55730 on gastrointestinal side-effects during and after anti-Helicobacter pylori treatment.

40 dyspeptic children, aged 3-18 years, with confirmed Helicobacter pylori infection were enrolled. They were treated with 10-day sequential antibiotic treatment and randomised to receive either Lactobacillus reuteri (10^8 CFU/day, n=20) or placebo (n=20) for 20 days, starting from the first day of treatment. The severity of side-effects was measured using a validated scoring system (GSRS score).

At entry, children in both groups had similar GSRS scores (6.9 in the Lactobacillus reuteri group and 7.1 in the placebo group), but during eradication therapy and follow-up, the Lactobacillus reuteri-supplemented children significantly improved their gastrointestinal health compared to the placebo group.

On day 10 the score was 4.1 in the Lactobacillus reuteri group vs. 6.2 in the placebo group (p<0.01) and on day 20 the scores were 3.2 and 5.8, respectively (p<0.009). The rates of Helicobacter pylori eradication were the same in the two groups.

ConclusionLactobacillus reuteri supplementation during and after Helicobacter pylori eradication therapy significantly reduced the frequency and intensity of antibiotic-associated side-effects.