Multispecies probiotics do not prevent antibiotic-associated diarrhea in children: JAMA

Netherlands: A new study published in the Journal of American Medical Association -- Pediatrics found that multispecies probiotics did not lower the risk of antibiotic-associated diarrhea (AAD) in kids but, decreased the overall risk of diarrhea both during and for seven days after receiving antibiotics.

It is yet unknown if multispecies probiotic compositions can effectively stop diarrhea brought on by antibiotics. In order to determine the impact of a multispecies probiotic on the risk of AAD in children, Jan ukasik and colleagues undertook this investigation.

In a multicenter, randomized study was carried out from February 2018 to May 2021. (inpatients and outpatients). Throughout the duration of the intervention, patients were monitored. Age requirements ranged from three months to eighteen years old, and other requirements included written informed permission and recruiting within 24 hours of starting broad-spectrum systemic antibiotics. 350 out of a total of 646 eligible patients that were contacted participated in the experiment. After testing for common diarrheal infections, the main result was AAD, which is defined as 3 or more loose or watery stools per day in a 24-hour period, either caused by Clostridioides difficile or of another unknown origin. Diarrhea of any cause, its duration, and specific diarrhea complications were among the secondary outcomes.

The key findings of this study were:

1. 350 kids were randomized, 313 of whom were included in the intention-to-treat analysis (192 males and 158 girls; mean age, 50 months).

2. Probiotic (n = 158) had no impact on risk of AAD compared to placebo (n = 155).

3. Regardless of the cause, children in the probiotic group had a decreased probability of developing diarrhea.

4. For the majority of the secondary outcomes, including adverse events, there were no differences between the groups.

In conclusion, using the researched probiotic to reduce diarrhea in kids receiving antibiotic therapy is a possibility. This study also demonstrates that clinical trial results and their interpretation are significantly impacted by the AAD outcome criteria.

Reference: 

Łukasik J, Dierikx T, Besseling-van der Vaart I, de Meij T, Szajewska H, Multispecies Probiotic in AAD Study Group. Multispecies Probiotic for the Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Clinical Trial. JAMA Pediatr. 2022;176(9):860–866. doi:10.1001/jamapediatrics.2022.1973