Study shows consuming a probiotic yogurt drink can help to attenuate any antibiotic-induced disturbance to the gut microbiota.
The community of bacterial species that resides within our intestines is referred to as the gut microbiota. Moreover, this community plays an important role in the overall health of the host and with approximately 100 trillion micro-organisms, the gut microbiota can be thought of as a virtual organ of the body that impacts on a wide range of host systems. These effects are attributed to short-chain fatty acids (SCFAs) which are the main metabolic products of gut micro-organisms from the fermentation of dietary fibres and resistant starches.
Any alterations in the gut flora are thought to be the main reason for antibiotic-induced diarrhoea and one way of minimising this bothersome adverse effect is through the use of probiotics. In fact, a 2017 systemic review, observed that pooled incidence antibiotic-induced diarrhoea was reduced to 8% in those using probiotics compared to 17.7% in the control group. However, what is less clear, is the impact of a probiotic on faecal levels of SCFAs and whether the use of probiotics alongside antibiotics can mitigate the changes in gut microbiota following a course of antibiotic treatment.
This was the question posed by a team from the Department of Family Medicine, Georgetown University Medical Centre, Washington, US. They set out to determine whether a yogurt containing the probiotic, Bifidobacterium animalis subsp. Lactis BB-12 (BB-12), could protect against the antibiotic-induced disruptions in both faecal SCFAs levels and gut microbiota composition. The undertook a randomised, controlled trial, in all participants received a 7-day course of amoxicillin-clavulanate 875 mg twice daily. The intervention group received a 14-day supply of a probiotic yogurt with BB-12 and the other group a control yogurt although participants were blinded to which yogurt they received. Faecal samples were collected and analysed for SCFAs and gut microbiota composition at baseline and then after 7, 14, 21 and 30 days. The primary measure of interest was changes in the level of the SCFA, acetate.
A total of 56 individuals with a mean age of 29.4 years (gender was not reported) were randomised in a 2:1 fashion to either BB-12 yogurt (38) or control. There was a significant decrease in the primary measure following administration of the antibiotics of 20.3% on day 7 in the control group. In contrast, in the BB-12 group, the corresponding reduction was lower at 15.6%. However, by day 30, acetate levels in the control group were still 25.1% lower than baseline values but only 1.6% lower in the BB-12 group. Using a measure of gut microbiota diversity, the authors found that at days 21 and 30, there was a greater decrease in diversity in the control compared to the BB-12 group. From the participant perspective, by day 7, 42% of the control group reported at least one day of loose stools compared to 26% in the BB-12 group.
The authors concluded that concurrent administration of BB-12 with antibiotics was associated with a significantly smaller decrease in faecal SCFA levels and a more stable gut microbiota over time compared to a control yogurt.
Merenstein D et al. Bifidobacterium animalis subsp. lactis BB-12 Protects against Antibiotic-Induced Functional and Compositional Changes in Human Fecal Microbiome. Nutrients 2021