Articles
Year 2019
April 2019
30 April 2019

Restoring Gut Health with Hexbio® In the Course of Antibiotics

Antibiotics are the most commonly prescribed medications and has been used steadily over the past decade for the treatment of infections. Unfortunately, approximately 25% of patients experience gut complication from antibiotic use. Extensive clinical research have shown strong evidence for the use of probiotics – microbial cell preparation (MCP) in the prevention of antibiotic associated symptoms especially diarrhea.

RESTORING GUT HEALTH WITH HEXBIO® IN THE COURSE OF ANTIBIOTICS
By Annie Kong, MMedSc

Antibiotics are the most commonly prescribed medications and has been used steadily over the past decade for the treatment of infections caused by bacteria, fungi and certain parasites. Nevertheless, antibiotics treatment may lead to undesirable side effects from mild diarrhea to the admission to intensive care unit or even death1.

The overuse of these broad-spectrum antibiotics kills both the beneficial bacteria along with pathogenic bacteria in the gut and disrupts the healthy gut functions. In some cases, the use of antibiotics may increase the risk of Clostridium difficile infection (CDI) which can cause more severe symptoms, such as inflammation of the colon that can be life-threatening3.

Thus, it is of utmost importance to alleviate the undesirable side-effects of antibiotics on the interactions between human and microbial cells in the gut. Extensive research has documented considerable evidence for the use of probiotics – microbial cell preparation (MCP) in the prevention of antibiotic associated symptoms especially diarrhea. These beneficial microbes are believed to restore gut health through competition with pathogenic bacteria for colonization and nutrients; and stimulating the host immune function4.

In fact, some of the most recent clinical trials data meta-analyses have addressed the prevention of AAD by probiotics5, 6, 7.  For example, a meta-analysis paper published in 2012 by Hempel, analysed the results of 63 randomized double blind placebo control studies, and concluded the use of probiotic – MCP during antibiotic therapy among 12,000 patients resulted in 42% lower risk of developing AAD compared to those taking placebo5.

Nonetheless, it should be noted that not all probiotics – MCP have demonstrated to be effective in reducing the risk of AAD8, 9. Even though the most frequently studied bacterial strains for treating AAD are Lactobacillus and Bifidobacterium, the beneficial effects and functions of these microbes are strain-specific10.

Throughout a course of antibiotics therapy, probiotic preparation or MCP should be administered starting from the first day; to be taken at least 2 hours after each dose of antibiotic; and until at least a week or two after the course of antibiotics is completed, 11, 12. On balance, these beneficial microbial cells have good safety record and potential to reduce serious complication of antibiotics treatment, which suggests that administration of high-quality multi-strain MCP concurrently with antibiotics present a valuable adjunct to the therapy.

References

  1. Hurley BW, Nguyen CC. The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Archives of internal medicine. 2002 Oct 28;162(19):2177-84.
  2. McFarland L. Epidemiology, Risk Factors and Treatments for Antibiotic-Associated Diarrhea. Digestive Diseases. 1998;16(5):292-307.
  3. Bartlett J. Narrative Review: The New Epidemic of Clostridium difficile–Associated Enteric Disease. Annals of Internal Medicine. 2006;145(10).
  4. Parkes G, Sanderson J, Whelan K. The mechanisms and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhoea. The Lancet Infectious Diseases. 2009;9(4):237-244.
  5. Hempel S, Newberry S. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. JAMA. 2012;307(18):1959.
  6. Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic‐associated diarrhea. The Cochrane Library. 2015 Jan 1.
  7. Videlock EJ, Cremonini F. Meta‐analysis: probiotics in antibiotic‐associated diarrhoea. Alimentary pharmacology & therapeutics. 2012 Jun 1;35(12):1355-69.
  8. Allen S, Wareham K, Wang D, Bradley C, Hutchings H, Harris W et al. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet. 2013;382(9900):1249-1257.
  9. Allen S, Wareham K, Wang D, Bradley C, Sewell B, Hutchings H et al. A high-dose preparation of lactobacilli and bifidobacteria in the prevention of antibiotic-associated and Clostridium difficile diarrhoea in older people admitted to hospital: a multicentre, randomised, double-blind, placebo-controlled, parallel arm trial (PLACIDE). Health Technology Assessment. 2013;17(57).
  10. Rowland I, Capurso L, Collins K, Cummings J, Delzenne N, Goulet O et al. Current level of consensus on probiotic science-Report of an expert meeting- London, 23 November 2009. Gut Microbes. 2010;1(6):436-439.
  11. Boyanova L, Mitov I. Coadministration of probiotics with antibiotics: why, when and for how long?. Expert Review of Anti-infective Therapy. 2012;10(4):407-409.
  12. Biradar S, Bahagvati S, Shegunshi B. Probiotics And Antibiotics: A Brief Overview. The Internet Journal of Nutrition and Wellness. 2004;2(1).
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