HomeHealthcareMore probiotics, less antibiotics 

More probiotics, less antibiotics 

Will more probiotics and fewer antibiotics ever be possible? A meta-analysis published on 14.9.18/XNUMX/XNUMX on European Journal of Public Health it offers useful insights to political decision-makers who will be able to grasp it.

Antibiotics and antibiotic resistance, humans and animals

The World Health Organization adopted in May 2015 a comprehensive plan to manage the antibiotic resistance problem. With the aim of ensuring the prevention and treatment of infectious diseases with safe and effective drugs. (1)

'Antibiotics are drugs used to prevent and treat bacterial infections. Resistance to antibiotics occurs when bacteria change in response to the use of these medicines. Bacteria, not humans or animals, become resistant to antibiotics'(WHO, World Health Organization). 

The size of the problem is offered across the Atlantic by the CDC (Center for Disease Control and Prevention). According to the US health agency, about 2 million cases of infections with antibiotic-resistant bacteria occur in the United States each year, causing 23.000 deaths.

The reduction in the use of antibiotics it is therefore a shared need on a planetary level. Given that excessive use of these substances contributes to antibiotic resistance, health administrations recommend preventing their abuse. Avoiding their use, for example, for viral diseases such as colds, flu and other acute respiratory infections.

WHO then recommended the reduction of the use of these drugs in the livestock sector. The Guidelines published in November 2017 show how the overall consumption of essential antibiotics in medicine, in some countries, is absorbed by animal husbandry in a significant share, up to 80%. (2)

Probiotics and health

Probiotics are live microorganisms which, when administered in adequate quantities and times (at least one billion a day 3-4 weeks), can bring various benefits to human health. Initially used for the prevention and treatment of gastrointestinal diseases, probiotics have revealed the ability to strengthen the structure and function of the intestinal barrier, and thus of the immune system.

The scientific evidence recalled in the study in question also suggest the ability of probiotic supplementation to reduce the incidence and severity of common infectious diseases, including respiratory tract infections and diarrhea. (3) The use of probiotic supplements could therefore be associated with a reduced use of antibiotics.

Probiotics, the meta-analysis

The meta-analysis by Sarah King and collaborators, published in the European Journal of Public Health, considered the impact of supplementing with probiotics, compared to using antibiotics. In cases of acute infections - of the respiratory tract, lower digestive tract or acute otitis media - in (otherwise) healthy individuals of all ages.

The systematic review of randomized controlled trials included infants, children, adolescents, adults and the elderly from all countries and backgrounds, clinical or non-clinical. Infections eligible for study included acute respiratory tract infections (i.e. cold, flu, sinusitis, pharyngitis, acute bronchitis, pneumonia), acute otitis media, and acute lower digestive tract infections (diarrhea). Not even the gastrointestinal symptoms associated with antibiotics. 

Studies were included who evaluated any probiotic strain taken orally, alone or in combination with another probiotic strain. For a duration ranging from 4 days to 9 months (more than a month in most cases). In comparison with placebo or without treatment. 

On babies and children who have received probiotics containing Lactobacillus e Bifidobacterium, in the form of supplements and food products, antibiotic treatments were 29% less likely.

Probiotic supplementation reduced the incidence of common infectious diseases, including respiratory tract infections and diarrhea. It is also associated with a reduction in the duration of symptoms in children and adults prone to upper respiratory tract infections.

By reducing the occurrence, duration and / or severity of common acute infections, the administration of probiotics could therefore be considered a useful strategy to reduce the need for antibiotics. And thus help manage the health emergency of antibiotic resistance.

Dario Dongo and Carlotta Suardi

Footnotes

(1) General news on antibiotic resistance and WHO / WHO plan on http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

(2) Cf. WHO guidelines on use of medically important antimicrobials in food-producing animals, its http://www.who.int/foodsafety/areas_work/antimicrobial-resistance/cia_guidelines/en/

3) Sarah King, Daniel Tancredi, Irene Lenoir-Wijnkoop, Kelsie Gould, Hailey Vann, Grant Connors, Mary Ellen Sanders, Jeffrey A Linder, Andi L Shane, Dan Merenstein; Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysisEuropean Journal of Public Healthhttps://doi.org/10.1093/eurpub/cky185

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Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.

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Nutritionist biologist, ADA II level master at the University of Milan Bicocca. External lecturer at LUNEX University, Luxembourg.

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