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

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.