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Is there any evidence for probiotics (especially vsl#3) in treating post-infective traveller’s diarrhoea?

Associated tags: adjunct therapy, antibiotic-induced diarrhoea, diarrhoea, probiotics, travellers, vsl#3

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Question answered:28/02/08

Earlier this year the NLH Q&A Service answered “Is there any evidence to support the use of probiotics to prevent antibiotic induced diarrhoea, and if so, which probiotic is the most effective?” [1]

 

In 2006 the Public Health Agency of Canada published “Statement On Persistent Diarrhea In The Returned Traveller” [2], this reported:

 

“Probiotic agents, most commonly Lactobacillus or Saccharomyces, have been shown to be effective in reducing the duration and severity of acute diarrhea in adults and children, in preventing antibiotic-associated diarrhea, and possibly in reducing the frequency of relapse in C. difficile associated diarrhea. Some benefit has been shown in chronic diarrhea in children and persistent post-travel diarrhea. Both Lactobacillus and Saccharomyces can rarely cause serious infection, usually in immunocompromised hosts, but have not been associated with serious adverse effects in otherwise healthy patients treated for diarrheal syndromes.”

 

With specific regard to vsl#3 we found relatively few trials in Medline.  We found recent trials in radiation-induced diarrhea [3], chronic inflammatory bowel diseases [4], pouchitis [5], irritable bowel syndrome with bloating [6] but none specific to the question.  A search of Cochrane and Google Scholar also failed to find any specific trials.

 

References

1) http://www.tripanswers.org/Answer.aspx?QuestionId=1331
2) http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/06vol32/acs-01/index.html
3) http://www.ncbi.nlm.nih.gov/pubmed/17352022
4) http://www.ncbi.nlm.nih.gov/pubmed/17263590
5) http://www.ncbi.nlm.nih.gov/pubmed/16401690
6) http://www.ncbi.nlm.nih.gov/pubmed/16185307
 


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