Journal Mobile Options
Table of Contents
Vol. 78, No. 1, 2008
Issue release date: November 2008
Digestion 2008;78:13–17

Bifidobacterium longum PL03, Lactobacillus rhamnosus KL53A, and Lactobacillus plantarum PL02 in the Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Controlled Pilot Trial

Szymański H. · Armańska M. · Kowalska-Duplaga K. · Szajewska H.
aDepartment of Pediatrics, St. Hedwig of Silesia Hospital, Trzebnica, bDepartment of Pediatrics, District Hospital, Kielce, cDepartment of Pediatric Gastroenterology, Polish-American Children’s Hospital, Jagiellonian University, Cracow, and d2nd Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Aim: To determine the efficacy of a combination of Bifidobacterium longum PL03, Lactobacillus rhamnosus KL53A and Lactobacillus plantarum PL02 for the prevention of antibiotic-associated diarrhea in children. Methods: Seventy-eight children (age: 5 months to 16 years) with otitis media, and/or respiratory tract infections, and/or urinary tract infections were enrolled in a double-blind randomized control trial in which they received standard antibiotic treatment plus a food supplement containing 108 colony-forming units of B. longum, L. rhamnosus and L. plantarum (n = 40) or a placebo (n = 38) orally twice daily for the duration of antibiotic treatment. Results: Patients receiving probiotics had a similar rate of diarrhea (≧3 loose or watery stools/day for ≧48 h occurring during or up to 2 weeks after the antibiotic therapy) as those receiving placebo (relative risk 0.5, 95% CI 0.06–3.5). The mean number of stools per day was significantly lower in the experimental group (mean difference –0.3 stool/day, 95% CI –0.5 to –0.07). No adverse events were reported. Conclusion: The administration of the 3 probiotics did not significantly alter the rate of diarrhea, although it reduced the frequency of stools per day. As the overall frequency of diarrhea was surprisingly low, these results should be interpreted with caution.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Bartlett JG: Antibiotic-associated diarrhea. N Engl J Med 2002;346:334–339.
  2. Elstner CL, Lindsay AN, Book LS, Matsen JM: Lack of relationship of Clostridium difficile to antibiotic-associated diarrhea in children. Pediatr Inf Dis 1983;2:364–366.
  3. Barbut F, Meynard JL, Guiguet M, Avesani V, Bochet MV, Meyohas MC, Delmée M, Tilleul P, Frottier J, Petit JC: Clostridium difficile-associated diarrhea in HIV-infected patients: epidemiology and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol 1997;16:176–181.
  4. McFarland LV, Surawicz CM, Stamm WE: Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 1990;162:678–684.
  5. Bartlett JG, Chang TW, Gurwith M, Gorbach SL, Onderdonk AB: Antibiotic-associated pseudomembranous colitis due to toxin producing Clostridia. N Engl J Med 1978;298:531–534.
  6. Turck D, Bernet JP, Marx J, Kempf H, Giard P, Walbaum O, Lacombe A, Rembert F, Toursel F, Bernasconi P, Gottrand F, McFarland LV, Bloch K: Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 2003;37:22–26.
  7. Joint FAO/WHO Working Group Report on Drafting Guidelines for the Evaluation of Probiotics in Food: London, Ontario, 2002.
  8. Szajewska H, Ruszczynski M, Radzikowski A: Probiotics in the prevention of antibiotic-associated diarrhea in children: a meta-analysis of randomized controlled trials. J Pediatr 2006;149:367–372.
  9. Johnston BC, Supina AL, Vohra S: Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials. CMAJ 2006;175:377–383. Erratum in: CMAJ 2006;175:777.
  10. D’Souza AL, Rajkumar C, Cooke J, Bulpitt CJ: Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. Br Med J 2002;324:1361–1364.
  11. Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G: Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2002;16:1461–1467.
  12. Szajewska H, Mrukowicz J: Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea. Aliment Pharmacol Ther 2005;22:365–372.
  13. Hawrelak JA, Whitten DL, Myers SP: Is Lactobacillus rhamnosus GG effective in preventing the onset of antibiotic-associated diarrhoea: a systematic review. Digestion 2005;72:51–56.
  14. Kotowska M, Albrecht P, Szajewska H: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther 2005;21:583–590.
  15. Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ: Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr 1999;135:564–568.
  16. Tankanow RM, Ross MB, Ertel IJ, Dickinson DG, McCormick LS, Garfinkel JF: A double-blind, placebo-controlled study of the efficacy of Lactinex in the prophylaxis of amoxicillin-induced diarrhea. DICP 1990;24:382–384.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50