Probiotics for Antibiotic Diarrhea: Does BB-12 Help?

randomized-controlled-trial PMID: 38271205

Quick Summary: This study looked at whether a probiotic called BB-12 could help prevent diarrhea caused by antibiotics. Researchers tested different ways of taking the probiotic with antibiotics to see if it made a difference. The results are still being analyzed, but the study aimed to find the best way to use probiotics to protect your gut.

What The Research Found

This research is still ongoing, but the goal was to see if the probiotic Bifidobacterium lactis BB-12 could help prevent diarrhea that sometimes happens when you take antibiotics. The study looked at how BB-12 affected the gut's "good" bacteria and a substance called short-chain fatty acids (SCFAs), which are important for gut health. The researchers also wanted to find out the best time to take the probiotic – at the same time as the antibiotic or a few hours later.

Study Details

Who was studied: 118 healthy adults aged 18-65.

How long: The study lasted for the 7 days that participants took antibiotics, with follow-up on day 14.

What they took: All participants took a common antibiotic (amoxicillin-clavulanic acid) twice a day for 7 days. Some also took yogurt with or without the BB-12 probiotic. The yogurt was taken either at the same time as the antibiotic or 4 hours later.

What This Means For You

If you're taking antibiotics, you might be at risk for diarrhea. This research is trying to find out if taking a probiotic like BB-12 can help. While the results aren't available yet, the study is exploring the best way to use probiotics alongside antibiotics. This could mean taking a probiotic at a different time than your antibiotic to help it work better.

Talk to your doctor: Before taking any new supplements, especially if you're on medication, talk to your doctor.

Consider probiotics: If you're taking antibiotics and experience diarrhea, your doctor might recommend a probiotic.

Timing matters: The study suggests that the timing of taking a probiotic with antibiotics could be important.

Study Limitations

Results are pending: The study's results are still being analyzed, so we don't know if BB-12 actually works.

Small study: The study included a limited number of people, so the results might not apply to everyone.

More research needed: More studies are needed to confirm these findings and to see if BB-12 is effective.

Key Findings

This pilot study aimed to evaluate whether the probiotic Bifidobacterium lactis BB-12 could mitigate antibiotic-associated diarrhea (AAD) by preserving short-chain fatty acid (SCFA) levels (primarily acetate) and stabilizing gut microbiota during amoxicillin-clavulanic acid treatment. While the study concluded data collection in December 2022, results were still under analysis at the time of publication (2024), with full outcomes expected by July 2023. No quantitative findings are reported in the provided summary, but the trial sought to address critical gaps in probiotic efficacy, particularly timing of administration relative to antibiotics.

Study Design

A five-arm randomized controlled trial (RCT) conducted within the Capital Area Primary Care Practice-Based Research Network. The study enrolled 118 generally healthy adults (18–65 years) prescribed a 7-day course of amoxicillin-clavulanic acid 875mg twice daily. Participants were divided into five groups: (1) antibiotic-only control, (2) antibiotic + probiotic yogurt (BB-12) taken concomitantly, (3) antibiotic + control yogurt concomitantly, (4) antibiotic + probiotic yogurt taken 4 hours post-antibiotic, and (5) antibiotic + control yogurt 4 hours post-antibiotic. Gut microbiota composition (via 16S rDNA profiling) and SCFA levels were measured, alongside clinical diarrhea incidence.

Dosage & Administration

BB-12 was administered in yogurt at an unspecified dose (likely ≥1×10^9 CFU/day, based on standard probiotic dosing). Timing varied: two groups consumed yogurt (probiotic or control) simultaneously with antibiotics, while two groups consumed it 4 hours after antibiotic doses. The intervention duration matched the 7-day antibiotic course, with outcomes assessed on day 14.

Results & Efficacy

The summary does not provide quantitative results or statistical significance (p-values, confidence intervals) due to ongoing analysis. However, the trial was designed to detect changes in acetate concentrations (primary outcome) and microbiota diversity (secondary outcome) between groups. The hypothesis was that BB-12 would attenuate antibiotic-induced SCFA reduction and microbiome disruption, with potential superiority of delayed administration (4-hour separation) to minimize antibiotic-probiotic interactions.

Limitations

As a pilot study, this trial had a relatively small sample size (n=118) and limited duration (14 days), potentially underpowered to detect subtle microbiome shifts or long-term effects. The lack of published results at the time of the summary introduces uncertainty about efficacy. Additionally, the yogurt vehicle may confound outcomes due to its inherent nutritional content (e.g., prebiotics, potassium) influencing SCFA or microbiota. No details on blinding or placebo control were specified, risking performance bias. Future research requires larger trials with diverse antibiotic regimens and probiotic strains.

Clinical Relevance

If BB-12 proves effective, this study could guide probiotic timing during antibiotic therapy to reduce AAD risk. Pending results, clinicians may consider recommending probiotic separation (e.g., 4 hours post-antibiotic) to optimize microbial survival. However, without published data, current evidence remains insufficient to endorse BB-12 specifically for AAD prevention. Users should prioritize probiotics with established evidence (e.g., Lactobacillus rhamnosus GG) until results clarify BB-12’s role. The study underscores the need for standardized protocols in probiotic research.

Note: The provided analysis is based on the trial’s design and stated objectives, as no final results were available in the summary.