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Colon/Small Bowel

The Effect of a Multispecies Probiotic on the Intestinal Microbiota and Bowel Movements in Healthy Volunteers Taking the Antibiotic Amoxycillin

The American Journal of Gastroenterology volume 103, pages 178189 (2008) | Download Citation

Subjects

Abstract

BACKGROUND:

One of the side effects of antimicrobial therapy is a disturbance of the intestinal microbiota potentially resulting in antibiotic-associated diarrhea (AAD). In this placebo-controlled double-blind study, the effect of a multispecies probiotic on the composition and metabolic activity of the intestinal microbiota and bowel habits was studied in healthy volunteers taking amoxycillin.

METHODS:

Forty-one healthy volunteers were given 500 mg amoxycillin twice daily for 7 days and were randomized to either 5 g of a multispecies probiotic, Ecologic® AAD (109 cfu/g), or placebo, twice daily for 14 days. Feces and questionnaires were collected on day 0, 7, 14, and 63. Feces was analyzed as to the composition of the intestinal microbiota, and β-glucosidase activity, endotoxin concentration, Clostridium difficile toxin A, short chain fatty acids (SCFAs), and pH were determined. Bowel movements were scored according to the Bristol stool form scale.

RESULTS:

Mean number of enterococci increased significantly from log 4.1 at day 0 to log 5.8 (day 7) and log 6.9 (day 14) cfu/g feces (P < 0.05) during probiotic intake. Although no other significant differences were observed between both intervention groups, within each group significant changes were found over time in both microbial composition and metabolic activity. Moreover, bowel movements with a frequency ≥3 per day for at least 2 days and/or a consistency ≥5 for at least 2 days were reported less frequently in the probiotic compared to the placebo group (48% vs 79%, P < 0.05).

CONCLUSIONS:

Apart from an increase in enterococci no significant differences in microbial composition and metabolic activity were observed in the probiotic compared with the placebo group. However, changes over time were present in both groups, which differed significantly between the probiotic and the placebo arm, suggesting that the amoxycillin effect was modulated by probiotic intake. Moreover, the intake of a multispecies probiotic significantly reduced diarrhea-like bowel movements in healthy volunteers receiving amoxycillin.

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Acknowledgements

The authors would like to thank Ing. M. Hazen and L. Hoffman for their technical assistance and B. Winkens, Ph.D., for his help with the statistical analyses. This research was funded by SenterNovem, an agency of the Dutch Ministry of Economic Affairs (grant no. TSGE 1041).

Author information

Affiliations

  1. Division of Gastroenterology-Hepatology, University Hospital Maastricht, Maastricht, The Netherlands

    • Catherina JM Koning
    • , Daisy MAE Jonkers
    •  & Reinhold W Stockbrügger
  2. Department of Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands;

    • Daisy MAE Jonkers
    •  & Ellen E Stobberingh
  3. Winclove Bio Industries B.V., Amsterdam, The Netherlands;

    • Linda Mulder
  4. Laboratory of Food Microbiology, Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, The Netherlands

    • Frans M Rombouts

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Correspondence to Catherina JM Koning.

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DOI

https://doi.org/10.1111/j.1572-0241.2007.01547.x

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