Evidence supporting the use of: Lactobacillus (various species)
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 side effects of antibiotics, particularly antibiotic-associated diarrhea (AAD). The scientific evidence supporting this use is substantial. Multiple randomized controlled trials and meta-analyses have shown that Lactobacillus-containing probiotics can reduce the risk of AAD in both adults and children. The proposed mechanism involves restoring the balance of the gut microbiota, which is often disrupted by antibiotics, leading to an overgrowth of pathogenic bacteria such as Clostridioides difficile. By replenishing beneficial bacteria, Lactobacillus helps maintain intestinal barrier function and modulate immune responses.

For example, a 2020 Cochrane review found that probiotics, including those with Lactobacillus strains, significantly lowered the incidence of antibiotic-associated diarrhea compared to placebo. The effect appears more pronounced when probiotics are started early, within 2 days of antibiotic initiation. Common strains used include L. rhamnosus GG and L. acidophilus. While not all studies show benefit, and the magnitude of effect can vary, the overall body of evidence strongly supports the use of certain Lactobacillus probiotics to mitigate AAD, with a good safety profile in most populations. However, probiotics should be used cautiously in immunocompromised individuals or those with severe underlying illness.

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