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Probiotics reduce antibiotic utilization for common infections

In many countries, antibiotics are often prescribed for common infections. Even if these infections are caused by viruses, which cannot be killed by antibiotics. This practice contributes to the development of antibiotic resistance. Daily consumption of probiotics, however, can reduce the utilization of antibiotics.

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Antibiotic resistance is a worldwide problem

Earlier this year the WHO’s new Global Antimicrobial Surveillance System (GLASS) revealed a widespread occurrence of antibiotic resistance among 500,000 people with suspected bacterial infections across 22 countries. Resistance to penicillin – the medicine used for decades worldwide to treat pneumonia – ranged from zero to 51% among reporting countries. And between 8% to 65% of E. coli associated with urinary tract infections presented resistance to ciprofloxacin, an antibiotic commonly used to treat this condition.(1) An important contributor to the increasing number of antibiotic resistant pathogens is the large number of unnecessary antibiotic prescriptions.  

 

Can probiotics reduce the number of antibiotic prescriptions?

Evidence suggest that probiotics can reduce episodes of common infectious diseases including respiratory tract infections, as well as reduce the duration of symptoms in otherwise healthy children and adults with common acute respiratory conditions. This may affect the number of antibiotic prescriptions for these diseases. In order to explore whether this is the case, an international group of scientists performed a systematic review with meta-analysis on randomized controlled trials (RCTs) in which probiotic supplementation was provided to reduce the risk for common acute infections in healthy people of all ages (2).

Meta-analysis finds a reduction of 53% 

After careful selection, 12 studies were included in the meta-analysis. The most commonly reported outcome was the incidence of infants and children who received an antibiotic while consuming probiotics to reduce the risk for acute respiratory and gastrointestinal infections.

The meta-analysis showed a reduction of 29% in antibiotic prescriptions for children consuming a daily supplement of probiotics compared to placebo.

The reduction of antibiotic prescriptions even increased to 53% after a sensitivity analysis of only those studies with a low risk of bias.

Meta-analysis shows:

 

Daily consumption of probiotics can reduce antibiotic prescription up to 53%

 

 

Probiotics may fulfil the need ‘to do something’

According to the study’s senior investigator, Daniel Merenstein, MD, the findings are very intriguing. “Given this finding, potentially one way to reduce the use of antibiotics is to use probiotics on a regular basis,” he says. First, probiotics may impact the number of antibiotic prescriptions because they reduce the risk for common illnesses, according to the researchers. If fewer common infections occur, there are fewer physician visits and therefore, fewer opportunities for antibiotics to be prescribed.

Second, probiotic consumption has been shown to reduce duration of symptoms. If an infection resolves more quickly, there is a good probability that a person will seek less medical care, reducing the opportunity for an antibiotic to be prescribed.

Third, probiotic consumption may simply be a replacement for antibiotics as patients and clinicians manage self-limited illnesses. The recommendation to take a probiotic may offer an intervention that can fulfil the need to ‘do something’.

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References

  1. World Health Organization. (2017). Global antimicrobial resistance surveillance system (GLASS) report: early implementation 2016-2017. In Global antimicrobial resistance surveillance system (GLASS) report: early implementation 2016-2017. https://www.who.int/mediacentre/news/releases/2018/antibiotic-resistance-found/en/
  2. King, S., Tancredi, D., Lenoir-Wijnkoop, I., Gould, K., Vann, H., Connors, G., ... & Merenstein, D. (2018). Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysis. European journal of public health.
  3. Probiotic use may reduce antibiotic prescriptions, researchers say [news release]. Georgetown University Medical Center website. Published September 14, 2018. gumc.georgetown.edu/news/Probiotic-Use-May-Reduce-Antibiotic-Prescriptions. Accessed October 18, 2018.

 

 

  

 

 

 

 

Daily consumption of probiotics reduces the number of antibiotic prescriptions in children, a meta-analysis found.

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