Influence of a probiotic mixture on antibiotic induced microbiota disturbances

Table 1 Demographic description of the enrolled volunteers n (%)

	Probiotic (n = 40)	Placebo (n = 40)	P value
Female	20 (50)	20 (50)
Male	20 (50)	20 (50)
Age (yr)	33.7 ± 9.4	30.9 ± 10.3	0.164
Weight (kg)	72.5 ± 12.9	71.5 ± 12.1	0.706
Height (cm)	171.2 ± 8.7	170.5 ± 10.3	0.766
BMI (kg/m²)	24.7 ± 3.5	24.5 ± 2.7	0.743
Hispani or Latino	4 (10)	6 (16)
African American	3 (7)	1 (2)
White	29 (73)	32 (80)
Other	4 (10)	1 (2)
Alcohol use
None	8 (20)	14 (35)	0.013
Occasionally	28 (70)	15 (38)
Weekly	4 (10)	11 (28)
Ex-smoker	2 (5)	4 (10)
n	38 (95)	36 (90)

BMI: Body mass index.

Table 2 Bacterial counts

	Probiotic	P value (within group)	Placebo	P value
				Within group	Between group
Total bacteria
Baseline	10.89 ± 0.22	-	10.81 ± 0.23	-	0.067
End of antibiotic + probiotic/placebo	10.58 ± 0.43	< 0.001	10.49 ± 0.38	< 0.001	0.177
End of probiotic/placebo	10.75 ± 0.30	0.003	10.77 ± 0.26	0.399	0.735
End of follow-up	10.87 ± 0.24	0.527	10.79 ± 0.31	0.568	0.221
Lactobacillus
Baseline	7.40 ± 0.79	-	7.42 ± 1.56	-	0.391
End of antibiotic + probiotic/placebo	7.13 ± 0.88	0.104	6.91 ± 1.45	0.032	0.642
End of probiotic/placebo	7.42 ± 0.77	0.944	7.07 ± 1.38	0.030	0.331
End of follow-up	7.16 ± 1.50	0.375	6.96 ± 1.87	0.149	0.851
Lactobacillus acidophilus ATCC 700396
Baseline	1.27 ± 2.20	-	0.93 ± 1.73	-	0.446
End of antibiotic + probiotic/placebo	2.39 ± 2.98	0.052	1.21 ± 2.07	0.407	0.035
End of probiotic/placebo	2.15 ± 2.79	0.245	0.79 ± 1.54	0.933	0.011
End of follow-up	1.60 ± 2.51	0.286	2.13 ± 2.74	0.021	0.498
Bifidobacterium
Baseline	8.62 ± 1.60	-	7.97 ± 1.99	-	0.087
End of antibiotic + probiotic/placebo	8.20 ± 1.08	0.016	7.83 ± 1.78	0.350	0.642
End of probiotic/placebo	8.72 ± 0.79	0.759	8.01 ± 2.13	0.805	0.142
End of follow-up	8.52 ± 1.60	0.466	8.12 ± 1.57	0.422	0.236
Bifidobacterium lactis
Baseline	8.81 ± 0.50	-	8.82 ± 0.69	-	0.914
End of antibiotic + probiotic/placebo	8.41 ± 1.48	0.054	8.20 ± 0.64	< 0.001	0.008
End of probiotic/placebo	8.79 ± 0.63	0.904	8.42 ± 0.67	< 0.001	0.013
End of follow-up	8.67 ± 0.49	0.206	8.49 ± 0.74	< 0.001	0.185
Bacteroides
Baseline	9.14 ± 0.56	-	8.97 ± 0.48	-	0.161
End of antibiotic + probiotic/placebo	9.06 ± 0.87	0.981	9.00 ± 0.61	0.629	0.345
End of probiotic/placebo	8.98 ± 0.69	0.050	8.85 ± 0.63	0.194	0.429
End of follow-up	9.14 ± 0.63	0.972	8.91 ± 0.54	0.479	0.079
Enterobacteriaceae
Baseline	6.92 ± 0.83	-	6.74 ± 1.33	-	0.734
End of antibiotic + probiotic/placebo	7.80 ± 1.16	< 0.001	7.68 ± 1.07	< 0.001	0.531
End of probiotic/placebo	6.88 ± 0.73	0.944	6.87 ± 0.72	0.732	0.947
End of follow-up	6.89 ± 0.55	0.956	6.75 ± 1.33	0.553	0.770
Clostridium difficile
Baseline	2.85 ± 1.44	-	2.90 ± 1.29	-	0.563
End of antibiotic + probiotic/placebo	3.42 ± 2.30	0.283	2.95 ± 2.54	0.632	0.281
End of probiotic/placebo	3.13 ± 1.42	0.566	2.56 ± 1.76	0.126	0.077
End of follow-up	3.08 ± 1.44	0.712	2.91 ± 1.68	0.475	0.935
Clostridium group XIV
Baseline	10.04 ± 0.24	-	9.92 ± 0.39	-	0.073
End of antibiotic + probiotic/placebo	9.36 ± 0.72	< 0.001	9.36 ± 0.45	< 0.001	0.582
End of probiotic/placebo	9.85 ± 0.32	< 0.001	9.74 ± 0.37	0.004	0.146
End of follow-up	9.94 ± 0.25	0.046	9.75 ± 0.36	0.006	0.011

Bacterial counts (log10 counts/g wet weight) at baseline (day 1), after 1 wk treatment period with antibiotic + probiotic or placebo (day 8), after 1 wk of supplementation with probiotic or placebo only (day 15) and after 1 wk follow-up period (day 22). Data are expressed as mean ± SD.

Table 3 Gastrointestinal Symptom Rating Scale scores for the study participants

		Probiotic		Placebo
		(n = 40)	P value(within group)	(n = 40)	P value
					Within group	Within group
Stomach ache or pain	Baseline	1.10 ± 0.38	-	1.32 ± 0.73	-	0.1011
	End of antibiotic	1.82 ± 1.32	0.0021	1.80 ± 1.26	0.0321	0.9911
	End of treatment	1.48 ± 1.22	0.1031	1.45 ± 1.01	0.6321	0.8291
	End of study	1.38 ± 0.98	0.1311	1.48 ± 1.15	0.6711	0.7411
Nausea	Baseline	1.00 ± 0.00	-	1.23 ± 0.66	-	0.0221
	End of antibiotic	1.50 ± 1.26	0.0221	1.60 ± 1.15	0.0881	0.3601
	End of treatment	1.27 ± 0.93	0.0541	1.15 ± 0.36	0.6081	0.8281
	End of study	1.12 ± 0.79	> 0.9991	1.15 ± 0.53	0.6081	0.1871
Rumbling in stomach	Baseline	1.55 ± 0.75	-	1.50 ± 0.75	-	0.7431
	End of antibiotic	1.95 ± 1.34	0.0381	1.80 ± 1.36	0.1871	0.2341
	End of treatment	1.73 ± 1.26	0.5651	1.42 ± 0.87	0.4881	0.2781
	End of study	1.50 ± 0.93	0.3881	1.35 ± 0.77	0.1791	0.2671
Bloated	Baseline	1.25 ± 0.44	-	1.30 ± 0.76	-	0.5471
	End of antibiotic	1.85 ± 1.48	0.0101	1.32 ± 0.76	0.9361	0.0711
	End of treatment	1.50 ± 0.96	0.1971	1.32 ± 0.80	> 0.9991	0.2421
	End of study	1.50 ± 0.88	0.0961	1.40 ± 1.08	0.7191	0.2961
Flatulus	Baseline	1.57 ± 0.81	-	1.52 ± 0.78	-	0.8341
	End of antibiotic	2.00 ± 1.36	0.0291	1.62 ± 0.98	0.8571	0.2391
	End of treatment	1.70 ± 1.30	> 0.9991	1.45 ± 0.99	0.3311	0.3031
	End of study	1.52 ± 1.13	0.2911	1.45 ± 0.85	0.4921	0.6891
Diarrhea	Baseline	1.18 ± 0.55	-	1.20 ± 0.79	-	0.5121
	End of antibiotic	1.92 ± 1.53	0.0011	1.73 ± 1.26	0.0501	0.6141
	End of treatment	1.45 ± 1.28	0.2601	1.20 ± 0.61	> 0.9991	0.6701
	End of study	1.35 ± 1.05	0.3891	1.15 ± 0.70	0.8921	0.0941
Loose stools	Baseline	1.25 ± 0.63	-	1.25 ± 0.71	-	0.7931
	End of antibiotic	1.70 ± 1.07	0.0021	1.48 ± 0.75	0.1091	0.4921
	End of treatment	1.48 ± 0.99	0.2411	1.20 ± 0.46	0.7841	0.3221
	End of study	1.25 ± 0.44	0.8241	1.27 ± 0.75	> 0.9991	0.5031
Bowel movement	Baseline	1.25 ± 0.67	-	1.40 ± 0.84	-	0.2911
	End of antibiotic	1.73 ± 1.20	0.0321	1.73 ± 1.06	0.1161	0.7391
	End of treatment	1.52 ± 1.13	0.2081	1.35 ± 0.77	0.8131	0.7121
	End of study	1.38 ± 1.10	0.7171	1.32 ± 0.86	0.5651	0.8161
Acid reflux	Baseline	1.55 ± 0.71	-	1.55 ± 0.64	-	0.8501
	End of antibiotic	1.60 ± 0.90	0.8051	1.55 ± 0.81	0.9601	0.8901
	End of treatment	1.52 ± 0.72	0.8941	1.35 ± 0.66	0.1291	0.2101
	End of study	1.27 ± 0.60	0.0341	1.35 ± 0.66	0.1621	0.4961
Constipation	Baseline	1.27 ± 0.51	-	1.25 ± 0.59	-	0.5171
	End of antibiotic	1.52 ± 1.15	0.2661	1.65 ± 1.25	0.0071	0.6251
	End of treatment	1.42 ± 1.11	0.8221	1.30 ± 0.76	0.8571	0.6051
	End of study	1.60 ± 1.24	0.1081	1.65 ± 1.25	0.0341	0.7081
Overal GSRS	Baseline	1.272 ± 0.280	-	1.322 ± 0.319	-	0.4441
	End of antibiotic	1.60 ± 0.76	< 0.0011	1.54 ± 0.58	0.0071	0.9691
	End of treatment	1.45 ± 0.79	0.5091	1.28 ± 0.33	0.1921	0.4811
	End of study	1.36 ± 0.70	0.7401	1.32 ± 0.57	0.2641	0.8641

Data are expressed as mean ± SD.

¹After a P value indicates that it was obtained from a non-parametric test, such as the Wilcoxon or Mann-Whitney U test. This is done whenever the values being summarized are significantly non-normally distributed, as assessed by the Anderson-Darling test. GSRS: Gastrointestinal Symptom Rating Scale.