The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin

C.J.M. Koning, D.M.A.E. Jonkers, E.E. Stobberingh, L. Mulder, F.M. Rombouts, R.W. Stockbrügger

Research output: Contribution to journalArticleAcademicpeer-review

53 Citations (Scopus)

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 ß-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
Original languageEnglish
Pages (from-to)178-189
JournalAmerican Journal of Gastroenterology
Volume103
Issue number1
DOIs
Publication statusPublished - 2008

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Amoxicillin
Probiotics
Healthy Volunteers
Anti-Bacterial Agents
Placebos
Feces
Diarrhea
Enterococcus
Glucosidases
Gastrointestinal Microbiome
Volatile Fatty Acids
Double-Blind Method
Endotoxins
Habits

Keywords

  • chain fatty-acids
  • lactobacillus-gg
  • saccharomyces-boulardii
  • double-blind
  • bacterial metabolism
  • cefpodoxime proxetil
  • plantarum 299v
  • fecal enema
  • diarrhea
  • prevention

Cite this

Koning, C.J.M. ; Jonkers, D.M.A.E. ; Stobberingh, E.E. ; Mulder, L. ; Rombouts, F.M. ; Stockbrügger, R.W. / The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin. In: American Journal of Gastroenterology. 2008 ; Vol. 103, No. 1. pp. 178-189.
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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{\circledR} 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 {\ss}-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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author = "C.J.M. Koning and D.M.A.E. Jonkers and E.E. Stobberingh and L. Mulder and F.M. Rombouts and R.W. Stockbr{\"u}gger",
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The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin. / Koning, C.J.M.; Jonkers, D.M.A.E.; Stobberingh, E.E.; Mulder, L.; Rombouts, F.M.; Stockbrügger, R.W.

In: American Journal of Gastroenterology, Vol. 103, No. 1, 2008, p. 178-189.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin

AU - Koning, C.J.M.

AU - Jonkers, D.M.A.E.

AU - Stobberingh, E.E.

AU - Mulder, L.

AU - Rombouts, F.M.

AU - Stockbrügger, R.W.

PY - 2008

Y1 - 2008

N2 - 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 ß-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

AB - 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 ß-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

KW - chain fatty-acids

KW - lactobacillus-gg

KW - saccharomyces-boulardii

KW - double-blind

KW - bacterial metabolism

KW - cefpodoxime proxetil

KW - plantarum 299v

KW - fecal enema

KW - diarrhea

KW - prevention

U2 - 10.1111/j.1572-0241.2007.01547.x

DO - 10.1111/j.1572-0241.2007.01547.x

M3 - Article

VL - 103

SP - 178

EP - 189

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 1

ER -