Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis

Henry Wanyama; Tayyab S. Akhtar; Sameen Abbas

doi:10.5114/pg.2025.148486

eISSN: 1897-4317
ISSN: 1895-5770

Gastroenterology Review/Przegląd Gastroenterologiczny

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vol. 20

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Artykuł przeglądowy

Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis

Henry Wanyama

¹

,

Tayyab S. Akhtar

²

,

Sameen Abbas

³

Department of Internal Medicine, Moi Teaching and Referral Hospital, Kenya University of South Wales, Cardiff, United Kingdom
University of South Wales, Cardiff, United Kingdom Center for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi, Pakistan
Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan

Gastroenterology Rev 2025; 20 (1): 5–16

DOI: https://doi.org/10.5114/pg.2025.148486

Data publikacji online: 2025/03/16

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Introduction
Probiotics potentially mitigate diarrhea incidence and severity, but their effectiveness in antibiotic-associated diarrhea (AAD) remains debated.

Aim
This meta-analysis aimed to enhance evidence on probiotic use for AAD.

Methods
A systematic search of randomized controlled trials (RCTs) from 2010 to 2023 in PubMed, EMBASE, Scopus, and Google Scholar was conducted. Eligible studies underwent risk assessment with the RoB-2 tool and data extraction using the random effects model. Subgroup analyses evaluated age, sample size, and probiotic strains’ influence.

Results
Fifteen trials with 7427 participants were included. Overall quality was moderate. Pooled analysis favored probiotics, reducing AAD incidence by 40% (RR = 0.60, 95% CI: 0.43–0.82). This effect was consistent across subgroup analyses. Multistrain probiotics showed superior protection (RR = 0.40 vs. 0.9 or 0.6 for dual or single strains).

Conclusions
This review suggests that probiotics, especially multistrain combinations, mitigate AAD incidence. Future large-scale RCTs will address heterogeneity.

Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis

Henry Wanyama 1 , Tayyab S. Akhtar 2 , Sameen Abbas 3

Henry Wanyama

¹

,

Tayyab S. Akhtar

²

,

Sameen Abbas

³