Evidence supporting the use of: Adsorbant
For the health condition: Antibiotics (side effects of)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Adsorbents, such as activated charcoal or smectite (diosmectite), are used to help manage some of the gastrointestinal side effects of antibiotics, particularly antibiotic-associated diarrhea (AAD). The rationale is that adsorbents can bind toxins, bacterial byproducts, and excess fluids in the gut, thereby reducing irritation and symptoms like diarrhea. Several clinical studies, especially in children, have shown that certain adsorbents (notably diosmectite) can reduce the duration and severity of diarrhea, including that caused by antibiotics. For example, a number of randomized controlled trials have found diosmectite to be effective and safe for reducing AAD duration. However, the evidence for other adsorbents, such as activated charcoal, is less robust, and data on prevention (rather than symptom management) are limited.

Major guidelines (e.g., from the European Society for Paediatric Gastroenterology) sometimes mention adsorbents as adjunctive therapy for non-severe diarrhea but do not specifically endorse them for all cases of antibiotic side effects, and they are less commonly used in the United States. There is also a theoretical risk that adsorbents could reduce the absorption and efficacy of oral antibiotics if taken simultaneously, so timing and dosing are important. In summary, there is moderate scientific evidence for the use of some adsorbents, particularly diosmectite, to alleviate antibiotic-associated diarrhea, but not for other side effects or for all adsorbent types.

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