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

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Lactobacillus species are widely used as probiotics to help prevent or reduce the gastrointestinal side effects of antibiotics, particularly antibiotic-associated diarrhea (AAD). The rationale is that antibiotics often disrupt the natural balance of gut microbiota, leading to overgrowth of pathogenic bacteria such as Clostridioides difficile and a reduction in beneficial bacteria like Lactobacillus. Supplementing with Lactobacillus can help restore this balance.

Multiple randomized controlled trials and meta-analyses support this use. For example, a 2017 Cochrane review (Goldenberg et al., 2017) analyzed over 30 trials and concluded that probiotics, especially those containing Lactobacillus species, significantly reduce the risk of AAD in both children and adults. Another meta-analysis (Hempel et al., JAMA 2012) found similar results, with a notable reduction in the incidence of AAD among those who took probiotics during antibiotic therapy. Commonly studied strains include L. rhamnosus GG and L. acidophilus.

However, while the evidence is robust for reducing mild antibiotic-associated diarrhea, the benefit for preventing severe complications (e.g., C. difficile infection) is less clear, and effects may depend on the specific strain and patient population. Overall, Lactobacillus is one of the most evidence-based probiotic interventions for mitigating antibiotic side effects.

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