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Bitesize evidence - Studies give limited support to probiotics in diarrhoea

Q Do probiotics prevent antibiotic-associated diarrhoea in children?

Q Do probiotics prevent antibiotic-associated diarrhoea in children?


These authors searched multiple databases to find randomised controlled trials of probiotics (live microbial food ingredients) for the prevention of antibiotic-associated diarrhoea. Two reviewers independently evaluated each article for inclusion and extracted the data.

They resolved any discrepancies through discussion. The authors classified studies as being at low-, medium-, high-, or very high-risk for bias. The authors don't describe looking for unpublished studies. They ended up with six trials with a total of 766 patients (range = 18-269).

After extracting the data, the authors conclude that probiotics reduce the risk of diarrhea and that we would need to treat seven children to prevent one case of diarrhoea.

Level of evidence

1a- (systematic review of randomised trials displaying worrying heterogeneity).

Study design

Meta-analysis (randomised controlled trials)


Various (meta-analysis)

Bottom Line

Probiotics appear to prevent antibiotic-associated diarrhoea in children. However, the limited number of trials included in this study, their overall limited quality, and the potential for publication bias suggest that the data are too limited for certainty.

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