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Probiotics for the Prevention of Antibiotic-associated Diarrhea in Adults: A Meta-Analysis of Randomized Placebo-Controlled Trials
Meta-analysis of 36 randomized placebo-controlled trials (9,312 adults) estimated probiotics reduced antibiotic-associated diarrhea incidence (pooled RR 0.62) without increasing adverse events (RR 1.00).
Design
MA of RCTs; PubMed, Cochrane, EMBASE, Web of Science; random vs fixed effects; primary outcome AAD incidence.
Results (abstract)
- Trials / participants: 36 studies; 9,312 adults
- AAD: pooled RR 0.62 (95% CI 0.51–0.74)
- Subgroup robustness: protective effect remained when grouped by indication for antibiotics, probiotic duration, dose, and timing relative to antibiotics
- Adverse events: RR 1.00 (95% CI 0.87–1.14) — no significant excess with probiotics in pooled analysis
Evidence hygiene
Strain / formulation heterogeneity is high—this row is a class-level prevention summary, not a single-product hospital formulary decision by itself.
Publication
Liao W, Chen C, Wen T, Zhao Q. J Clin Gastroenterol. 2021 Jul 1;55(6):469-480. PMID 33234881.
Outcomes
- Pooled antibiotic-associated diarrhea incidence RR 0.62 (95% CI 0.51–0.74) with probiotics vs placebo (36 RCTs, n=9,312 adults).
- Adverse events pooled RR 1.00 (95% CI 0.87–1.14)—no significant excess with probiotics.