Randomized Controlled Trial
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2014; 20(33): 11878-11885
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11878
Influence of a probiotic mixture on antibiotic induced microbiota disturbances
Sofia Forssten, Malkanthi Evans, Dale Wilson, Arthur C Ouwehand
Sofia Forssten, Arthur C Ouwehand, Active Nutrition, DuPont Nutrition & Health, 02460 Kantvik, Finland
Malkanthi Evans, Dale Wilson, KGK Synergize, London, ON N6A 5R8, Canada
Author contributions: All authors contributed to the writing of the manuscript and interpretation of the data; Wilson D and Ouwehand AC designed the study; Forssten S performed the microbiota and antibiotic resistance analyses; Evans M performed the statistical analyses; Wilson D performed the study.
Supported by The study was commissioned and paid for by DuPont Nutrition & Health
Correspondence to: Arthur C Ouwehand, PhD, Research Manager, Active Nutrition, DuPont Nutrition & Health, Sokeritehtaantie 20, 02460 Kantvik, Finland. arthur.ouwehand@dupont.com
Telephone: +358-40-5956353 Fax: +358-10-4315601
Received: December 29, 2013
Revised: March 13, 2014
Accepted: May 12, 2014
Published online: September 7, 2014
Processing time: 252 Days and 10.2 Hours
Abstract

AIM: To study the effect of probiotic consumption on the faecal microbiota during and after antibiotic exposure.

METHODS: A randomized, double-blind, placebo-controlled, parallel group study with a two species probiotic combination [Lactobacillus acidophilus (L. acidophilus) ATCC 700396 and Bifidobacterium lactis (B. lactis) ATCC SD5220] on healthy adults during and after antibiotic treatment (amoxicillin 875 and 125 mg clavulanate). The dominant faecal microbiota was studied by real time-polymerase chain reaction to determine if this probiotic preparation could facilitate restoring the microbiota to its pre-antibiotic state and influence the prevalence of beta-lactam resistance. Gastrointestinal symptoms were recorded by questionnaire and Bristol stool scale.

RESULTS: Subjects on the probiotic combination had significantly higher faecal counts of L. acidophilus ATCC 700396 and B. lactis at day 8 (end of antibiotic treatment period) vs those on placebo. Furthermore, subjects on the probiotic combination had significantly higher faecal counts of L. acidophilus ATCC 700396 and B. lactis at Day 15 (end of probiotic treatment) vs those on placebo. Lactobacillus counts remained stable in the probiotic group over the course of the study, while Clostridium XIV group was higher at the end of the study and closer to baseline levels; this in contrast to the placebo group. Beta-lactam resistance in creased after antibiotic exposure and was not different between both treatment groups. Gastrointestinal symptoms were generally mild and did not differ between the treatment groups, which correlates with the generally small changes in the microbiota.

CONCLUSION: Consumption of the probiotic combination mainly leads to an increase in the faecal levels of the species included in the preparation.

Keywords: Probiotic; Antibiotic treatment; Amoxicillin/clavulanate; Microbiota; Beta-lactamases; Lactobacillus acidophilus; Bifidobacterium lactis

Core tip: The influence of a probiotic combination on the stability of the intestinal microbiota was studied using molecular techniques. Most published studies have relied on culturing or have only looked at symptomology. Furthermore, this was studied in a antibiotic challenge setting to limit variability.