Coadministration of Probiotics With Antibiotics

Why, When and for How Long?

Lyudmila Boyanova; Ivan Mitov

Disclosures

Expert Rev Anti Infect Ther. 2012;10(4):407-409. 

In This Article

Abstract and Introduction

Introduction

Probiotics, such as Lactobacillus spp., Bifidobacterium spp. and Saccharomyces boulardii, are living microorganisms that confer health benefits on the host. They are taken with food or as capsules/tablets and powder. Probiotics improve antibiotic therapy as they reduce microbial adhesion and growth by bacteriocins or other inhibitory compounds, possess immunomodulatory properties and improve intestinal barrier integrity.[1] In patients treated with antibiotics, probiotics promote the recovery of commensal microbiota and increase treatment tolerability.

Probiotics exhibit an excellent overall safety profile but should be used cautiously in severely immunocompromised patients and premature neonates. In fragile patients, there is a risk of bacteremia by some Lactobacillus spp. (e.g., Lactobacillus rhamnosus GG and Lactobacillus casei).[2]S. boulardii should be avoided in patients who are critically ill, at parenteral nutrition or with central venous catheters due to risk for fungemia.[3] Antibiotic resistance of the probiotic strains should be considered as it could be transferred to other species, although transfer from lactobacilli has been observed occasionally in vivo in diassociated animal models.[4]

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