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Botanicals and the Gut Microbiome
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
In many instances when antibiotics are taken by individuals, the gastrointestinal microbiota gets disturbed, which leads to diarrhea. This is a common occurrence when taking aminopenicillins, cephalosporins and clindamycins (Bull and Plummer, 2015). Antibiotic-associated diarrhea is normally associated with a reduction in the integrity of the intestinal wall and mineral and vitamin metabolism (Johnston et al., 2012). It is the dysbiosis of the intestinal microbiota and the subsequent overgrowth of the bacterial pathogens that makes this a common occurrence when taking certain antibiotics. The role of probiotics in the prevention of antibiotic-associated diarrhea is that probiotics have the ability to assist disrupted microbiota, enhancing a response from the host immune system to clear the pathogens from the host (McFarland, 2006).
Probiotic Dose-Response and Strain Number
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Several meta-analyses have done sub-group analysis on dose as shown in Table 1. The most convincing evidence for a dose-response effect was observed for Antibiotic Associated Diarrhoea (AAD). Interestingly, no such effect was observed for Clostridium (C.) difficile Associated Diarrhoea (CDAD) or authors concluded there was insufficient data; this despite the fact that 26 (Lau and Chamberlain 2016) or 31 (Lau and Chamberlain 2016) studies were included. Similarly, for Necrotising Enterocolitis (NEC) with 26 included studies, the authors conclude there was insufficient data (Aceti et al. 2015). Notwithstanding this, Deshpande and co-workers (Deshpande et al. 2011) recommend a dose of at least 3 × 109 CFU; this, based on the median dose used in studies. Meta-analyses on reducing blood pressure and weight management indicate doses of at least 1011 CFU and 3 × 1010 CFU, respectively, for benefits. For other health benefits, the authors conclude there is either no dose-response effect and/ or there is insufficient data. Another complicating factor may be that the range of tested doses is relatively narrow; making it unlikely to actually observe a difference even if it would exist.
The Role of the Microbiome on Human Health
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
Rodney R. Dietert, Janice M. Dietert
Overuse of antibiotics is recognized as a major factor in the depletion of the human microbiome and even when they are needed, these drugs are likely to kill commensal bacteria along with the pathogen (Blaser 2016). Investigators have argued that it is time to consider probiotics as an adjunct therapy for antibiotic administration. In particular, this has been advocated in the treatment of Clostridium difficile infection (Spinler et al. 2016). However, given the impact of antibiotics on the microbiome, adjunct therapies could help avoid the destruction of the microbiome and subsequent altered physiology, barrier function, and risk of inflammatory-driven diseases. A recent trial in children looked at the adjunct administration of yogurt containing three probiotic bacteria versus control pasteurized yogurt for children receiving prescribed antibiotics. The study reported that the probiotics group had a lower and less severe incidence of antibiotic-associated diarrhea (Fox et al. 2015).
The mechanisms and safety of probiotics against toxigenic clostridium difficile
Published in Expert Review of Anti-infective Therapy, 2020
Dianbin Liu, Lingbing Zeng, Zhihan Yan, Junqi Jia, Jing Gao, Yanxia Wei
Clostridium difficile (C. difficile) is an anaerobic Gram-positive, spore-forming bacterium, which is the main cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis in human. The pseudomembranous colitis and infrequent toxic megacolon caused by C. difficile infection (CDI) are potentially fatal [1]. With the emergence of hypervirulent strains, the incidence of CDI has increased significantly, which is becoming a public health problem [2,3]. The main virulence factors of C. difficile are Toxins A (TcdA) and Toxin B (TcdB). It was shown that several antibiotics were involved in antibiotic-associated diarrhea. The treatment of antibiotics allowed the colonization and growth of C. difficile [4,5] and CDI was responsible for the majority of antibiotic-associated diarrhea [6]. The frequency, duration of high-risk antibiotic therapy, and the number of antibiotics prescribed have been recommended to be minimized for reducing CDI risk [7]. In addition, the correlation between the usage of proton pump inhibitors (PPIs) and the increased risk of CDI has been recognized [8,9].
Improved gut microbiome recovery following drug therapy is linked to abundance and replication of probiotic strains
Published in Gut Microbes, 2022
Jamie FitzGerald, Shriram Patel, Julia Eckenberger, Eric Guillemard, Patrick Veiga, Florent Schäfer, Jens Walter, Marcus J Claesson, Muriel Derrien
Probiotics are efficacious in the treatment of antibiotic-associated diarrhea (reviewed in28), but it is unclear how they aid the restoration of the microbiome after antibiotics. We recently showed that the consumption of a multi-strain product consisting of yogurt and probiotic strains induces a faster recovery in subjects that undertook Hp eradication therapy, which was reflected by lower within-subject beta-diversity dissimilarity to baseline, enhanced short-chain fatty acids, and compositional differences in the fecal microbiota post-Hp treatment.24 Here, we used metagenomic approaches with strain-level resolution to determine the contribution of the individual bacterial strains to structural and functional recovery.
Clinical review of Clostridium difficile infection: an update on treatment and prevention
Published in Expert Opinion on Pharmacotherapy, 2018
Lindsay M. Daniels, Wesley D. Kufel
It is important to only test patients with symptoms and clinical findings consistent with CDI. Laboratories should only test liquid or unformed stool samples, and policies should be in place to allow for rejection of samples not meeting these criteria. Diarrhea is common in hospitalized patients and may be caused by factors other than CDI. Treatments such as laxatives, certain medications, and enteral feeding should be considered as potential causes of diarrhea in patients with suspected CDI. Non-C. difficile antibiotic-associated diarrhea is also common given the frequency with which antibiotics are prescribed in hospital settings [33]. In these patients, distinguishing between CDI and C. difficile colonization can be especially challenging.