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Probiotics are beneficial bacteria living in the microbiota ecosystem of the human body playing particular important roles in human health. The increasing rate of various diseases and the studies about the balance of gut microbiome made scientists trying to find novel therapies in this regard and hypothesize the relationships between the imbalance of gut microbiome and spread of various diseases especially in the immune system. Previous studies have indicated that when administrated in specific amounts, probiotics exert beneficial properties for human health such as antibacterial effects, cytotoxic effects, Hypocholesterolemic effects, immunomodulatory effects, wound healing effects etc. Probiotics also are known to produce nourishing healthy supplements for the human body such as vitamin K and B as well as healthy fatty acids. In this regard summarization of scientific evidence may help to familiarize the scientists with this novel area of research helping to find effective therapies for various disease. In this study, we used published literature in scientific databases such as Web of Science, Cochrane Library, Medline, PubMed, Science Direct, Scopus, as well as Google Scholar for data collection. So, the present review describes scientific-based evidence about probiotics and some of their beneficial effects to highlight the path for further researches about these beneficial bacteria.

Helicobacter pylori (Hp) eradication therapy alters gut microbiota, provoking gastrointestinal (GI) symptoms that could be improved by probiotics. The study aim was to assess the effect in Hp patients of a Test fermented milk containing yogurt and Lacticaseibacillus (L. paracasei CNCM I-1518 and I-3689, L. rhamnosus CNCM I-3690) strains on antibiotic associated diarrhea (AAD) (primary aim), GI-symptoms, gut microbiota, and metabolites. A randomised, double-blind, controlled trial was performed on 136 adults under 14-day Hp treatment, receiving the Test or Control product for 28 days. AAD and GI-symptoms were reported and feces analysed for relative and quantitative gut microbiome composition, short chain fatty acids (SCFA), and calprotectin concentrations, and viability of ingested strains. No effect of Test product was observed on AAD or GI-symptoms. Hp treatment induced a significant alteration in bacterial and fungal composition, a decrease of bacterial count and alpha-diversity, an increase of Candida and calprotectin, and a decrease of SCFA concentrations. Following Hp treatment, in the Test as compared to Control group, intra-subject beta-diversity distance from baseline was lower (padj = 0.02), some Enterobacteriaceae, including Escherichia-Shigella (padj = 0.0082) and Klebsiella (padj = 0.013), were less abundant, and concentrations of major SCFA (p = 0.035) and valerate (p = 0.045) were higher. Viable Lacticaseibacillus strains were detected during product consumption in feces. Results suggest that, in patients under Hp treatment, the consumption of a multi-strain fermented milk can induce a modest but significant faster recovery of the microbiota composition (beta-diversity) and of SCFA production and limit the increase of potentially pathogenic bacteria.

The present study aimed to investigate whether probiotic recovery is affected when consumed together with antibiotics. Fecal samples were collected from an earlier antibiotic associated diarrhea, randomized, placebo-controlled study with a product consisting of a combination of Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, and Bifidobacterium lactis Bi-07, B. lactis Bl-04 at equal numbers and at a total dose of 1010 CFU. Fecal samples were collected during the screening visit (T0), i.e., at the time of antibiotic prescription, and then on the last day of the antibiotic treatment (T1) as well as seven days after the subject had stopped taking the antibiotic treatment (T2) and at two weeks after completing antibiotic treatment and one week after probiotic/placebo consumption stopped (T3). Samples were analyzed for the presence of the four administered strains. The study was registered at clinicaltrials.gov as NCT01596829. Detection levels of all four strains were significantly increased from T0 to T1 and returned to baseline level from T2 to T3. There were also significantly more subjects with detectable levels of L. paracasei Lpc-37, B. lactis Bi-07, and B. lactis Bl-04 at T1 and T2 compared to T0 and T3, and compared to placebo. Each of the four strains could be detected in the feces of patients apparently unaffected by the simultaneous consumption of antibiotics.

Clostridium difficile (C. diff) is the most common causative agent of antibiotic-associated diarrhea and colitis. This spore-forming, obligate anaerobic, gram-positive bacillus is becoming responsible for an increasing number of infections worldwide, both in community and in hospital settings, whose severity can vary widely from an asymptomatic infection to a lethal disease. While discontinuation of antimicrobial agents and antibiotic treatment of the infection remain the cornerstone of therapy, the use of probiotics, especially Saccharomyces boulardii, and more recently of fecal microbiota transplantation have become valid forms of prevention and/or therapy and are here critically examined.

The aim of this paper is to specify the use of clinically proven probiotics in common pediatric gastrointestinal disorders. The PubMed and Cochrane Library databases were searched in May and June 2018, using the following key words: „probiotics“, „children“, „antibiotic associated diarrhea“, „acute gastroenteritis“, and „functional gastrointestinal disorders“. Only studies published in English and published data were considered. The search included clinical trials, systematic reviews, guidelines and recommendations for clinical practice, and only relevant, high-quality and recent data were taken into account. Probiotics in general are nowadays used for numerous clinical indications and there is also a very large and still growing number of papers addressing this issue. Conclusion – According to current knowledge, two probiotic strains are recommended for antibiotic associated diarrhea prevention and treatment of acute gastroenteritis, LGG and S. boulardii. For the strain L. reuteri DSM 17938 there is a weak recommendation for treatment of acute gastroenteritis. There are still not enough data to recommend the use of probiotics in pediatric functional gastrointestinal disorders, with the exception of L. reuteri DSM 17938 for treatment of infantile colic in breastfed infants.

Clostridium difficile is an uncommon cause of reactive arthritis in children. We herein present a rare case of C. difficile infection-associated reactive arthritis (CDIAReA) in a child, who developed severe diarrhea and a knee effusion following a course of oral antibiotic treatment. Our report emphasizes that CDIAReA should be considered in the differential diagnosis of children presenting with acute and painful arthritis that develops in the setting of antibiotic associated diarrhea. © 2018 by Pediatric.

Antibiotic associated diarrhea (AAD) is a common complication in childhood in the outpatient and inpatient settings. This review provides up to date information on the use of probiotics in the prevention and treatment of AAD, including that from Clostridium Difficile, in children. The most recently systematic reviews and subsequently published randomized controlleds trials are considered. Different single and multistrain probiotics are described; a specific recommendation for the use of Lactobacillus Rhamnosus GG (LGG) and Saccharomyces boulardii (Sb) emerges. New information on LGG survival under amoxicillin/clavulanate therapy in children is also provided. This information is relevant in view of the frequent use of this molecule in children, its association with AAD, and LGG's sensitivity to penicillin that might make this probiotic ineffective. In spite of a demonstrated positive effect of specific strains of probiotics on AAD, safety issues still remain among which the risk of associated severe infections and of antibiotic resistant gene exchange.

Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing eitherLactobacillusalone or in combination withBifidobacteriumreduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administeredLactobacillus caseisubspeciesrhamnosus,Lactobacillus reuteri, andLactobacillus rhamnosuswere effective in the prevention of late-onset sepsis and GIT colonization byCandidain preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization byCandida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics, optimum dosage regimens and duration of treatment, cost effectiveness, and risk-benefit potential for the prevention and treatment of various critical illnesses.

In recent decade the prevalence of antibiotic associated diarrhea was increased because of more antibiotic usage. Colstridum difficile is a microorganism which can cause mild to severe colitis. But the only cause of colitis related to Antibiotics is not colstridum difficle. In this case report we explain a child whit antibiotic associated colitis due to klebsiella oxtyoca.

Introduction Antibiotic associated diarrhea (AAD) is a frequently encountered adverse event following antibiotic administration. Evidence suggests that probiotics may be beneficial in preventing and decreasing the severity of AAD. Material and methods Adult patients who were prescribed antibiotics for 3-14 days were enrolled from eight Canadian centers. Study treatment was randomized at a 1 : 1 ratio of BIO-K+CL1285® or placebo and was administered within 24 h of initiation to 5 days after termination of antibiotherapy. Patients were followed for 21 days after last dose of study treatment. The primary outcome was severity and incidence of AAD. Severity was measured by the total number of days with diarrhea and incidence was defined as the number of patients with at least one day with diarrhea over the total number of patients enrolled in the study. Results 216 patients were randomized to BIO-K+ and 221 to placebo. The mean (SD) number of days with diarrhea was 1.19. (3.20) days for the placebo and 0.67 (2.05) days for BIO-K+CL1285® (p = 0.040). Adjusted multivariate linear regression results showed that the duration of diarrhea for BIO-K+CL1285 ® vs. placebo was reduced by 51.5% (b[SE] = 0.515 [0.256], p = 0.045). The incidence of diarrhea was 21.8% for the BIO-K+ and 29.4% for the placebo group (OR = 0.667, p = 0.067). Multivariate logistic regression, showed that the adjusted odds ratio of AAD in patients receiving BIO-K+ vs. placebo was 0.627 (p = 0.037). Study treatment was well tolerated. Conclusions BIO-K+ is effective for preventing and reducing the severity of AAD in patients receiving antibiotic therapy in a hospital setting.

Resume Les diarrhees aigues constituent un probleme de sante publique du fait de leur grande frequence. Leur origine est presque toujours infectieuse et leur evolution spontanement resolutive, le plus souvent en moins de 3 jours. Seul 1 % des diarrhees necessite d'emblee des explorations complementaires, notamment des examens de selles, car leur presentation clinique evoque une colite aigue sous-jacente (selles sanglantes, douleurs abdominales circonscrites), du fait d'un terrain fragile sous-jacent avec un risque immediat pour le malade, ou d'un contexte particulier (sejour sous les tropiques…). Ces examens de selles doivent etre orientes afin de guider le biologiste et ameliorer la rentabilite des prelevements, qui s'avere sinon tres faible et couteuse a l'echelle d'une population. Une antibiotherapie empirique basee essentiellement sur les fluoroquinolones est ensuite licite dans ces cas selectionnes, en attendant les resultats des examens. Ces explorations sont aussi justifiees lorsque la diarrhee persiste au-dela de 3 jours. Enfin, lorsque l'episode se prolonge au-dela de 5 jours, avec des prelevements de selles negatifs, un avis specialise est necessaire. Ainsi, seule une petite proportion de ces diarrhees aigues va necessiter une endoscopie, permettant de parler ainsi de colite ou de rectocolite. Au plan therapeutique, la rehydratation precoce chez l'enfant reste d'actualite car elle a prouve son efficacite en termes de mortalite depuis plus de deux decennies, principalement dans les pays en voie de developpement.