Bacterial Diarrhea, Including Traveler's Diarrhea
Overall results of studies of probiotics for use in treatment or prevention of bacterial diarrhea, other than C difficile , are mixed. Many studies have evaluated the efficacy of probiotics in preventing traveler's diarrhea. In a study of 820 travelers to 2 resorts in Turkey, LGG failed to affect the overall rate of diarrhea (43% of controls versus 38% in the LGG). However, in 1 resort, the diarrhea rate was 40% for controls compared with 24% of the LGG-treated travelers. In a second study, travelers were monitored by a hospital-based Travel and Immunization Center. Destinations varied and compliance with the study drug (placebo or LGG) was good in 245 participants. Overall the incidence of traveler's diarrhea averaged 7.4%/d for the placebo group and 3.9%/d for the probiotic group. In a study of healthy volunteers fed enterotoxigenic Escherichia coli , there was no benefit from concurrent administration of lactobacilli. Results of other studies of probiotics alone or in combination for prevention of traveler's diarrhea are conflicting. Cost-benefit analysis studies are needed to determine whether a marginal reduction in traveler's diarrhea warrants treatment of all travelers.
The effects of probiotics for other pathogenic bacteria are variable. A study of E faecium in 183 Bangladeshi adults with acute diarrhea caused by Vibrio cholera , enterotoxigenic Escherichia coli or unknown organisms did not shown efficacy. Although some studies with L. acidophilus have shown an effect against bacterial causes of enteritis and Bifidobacterium breve has been somewhat effective against Campylobacter , most studies of probiotics for treatment of patients with bloody diarrhea have not shown a benefit.
Pediatr Infect Dis J. 2005;24(3):267-268. © 2005 Lippincott Williams & Wilkins
Cite this: Probiotics and the Treatment of Infectious Diarrhea - Medscape - Mar 01, 2005.