Abstract
Antibiotic use is considered among the most severe causes of disturbance to children’s developing intestinal microbiota, and frequently causes adverse gastrointestinal effects ranging from mild and transient diarrhoea to life-threatening infections. Probiotics are commonly advocated to help in preventing antibiotic-associated gastrointestinal symptoms. However, it is currently unknown whether probiotics alleviate the antibiotic-associated changes in children’s microbiota. Furthermore, it is not known how long-term probiotic consumption influences the developing microbiota of children. We analysed the influence of long-term Lactobacillus rhamnosus GG intake on preschool children’s antibiotic use, and antibiotic-associated gastrointestinal complaints in a double blind, randomized placebo-controlled trial with 231 children aged 2–7. In addition, we analysed the effect of L. rhanmosus GG on the intestinal microbiota in a subset of 88 children. The results show that long-term L. rhamnosus GG supplementation has an influence on the composition of the intestinal microbiota in children, causing an increase in the abundance of Prevotella, Lactococcus, and Ruminococcus, and a decrease in Escherichia. The treatment appeared to prevent some of the changes in the microbiota associated with penicillin use, but not those associated with macrolide use. The treatment, however, did reduce the frequency of gastrointestinal complaints after a macrolide course. Finally, the treatment appeared to prevent certain bacterial infections for up to 3 years after the trial, as indicated by reduced antibiotic use.Trial Registration: ClinicalTrials.gov NCT01014676
Highlights
Antibiotics account for the majority of prescription medication used by children in western countries [1] and relatively frequently cause diarrhoea in this demographic [2], which indicates that antibiotic use influences intestinal health
L. rhamnosus GG supplementation caused a reduction in antibiotic use
Macrolide use was associated with strong changes in the microbiota, which the L. rhamnosus GG treatment did not prevent completely
Summary
Antibiotics account for the majority of prescription medication used by children in western countries [1] and relatively frequently cause diarrhoea in this demographic [2], which indicates that antibiotic use influences intestinal health. Antibiotic use has been implicated as the strongest and the most common cause of disturbance to the intestinal microbiota [3]. Animal experiments have demonstrated that early-life antibiotic use disrupts the microbiota and immune function and metabolism, predisposing to the development of obesity [13,14] and allergic disease [15,16]. The association between antibiotic use and the development of asthma in children has been established, causality is yet to be confirmed [21]. Due to these potentially detrimental changes, there is a need to mitigate the damage antibiotics cause on the symbiotic microbiota. One commonly advocated option is the use of specific microorganisms that are marketed as probiotics
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