Probiotics to minimize the disruption of faecal microbiota in healthy subjects undergoing antibiotic therapy

1 Department of Energy Joint Genome Institute, Walnut Creek, CA, USA 2 Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA 3 Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, USA 4 Dairy and Food Culture Technologies, Centennial, CO, USA 5 North Carolina State University, Raleigh, NC, USA 6 Cultures Division R&D, Danisco, Madison, WI, USA 7 Environmental Biotechnology Institute, California Polytechnic State University, San Luis Obispo, CA, USA Correspondence Christopher L. Kitts ckitts{at}calpoly.edu Received September 6, 2007 Accepted January 25, 2009 A novel combination of culturing and DNA-based terminal restriction fragment length polymorphism (TRFLP) analysis was used to investigate the effect of probiotics on antibiotic-induced gut microbiota alterations to determine if a probiotic preparation containing bifidobacteria and lactobacilli, taken during and after antibiotic therapy, can minimize antibiotic disturbance of faecal microbiota. Healthy subjects administered amoxicillin/clavulanate were randomized and concomitantly received a placebo or probiotic mixture. The primary end point was similarity of faecal microbiota as determined by culturing and TRFLP from subjects taking probiotics compared to those taking a placebo measured by comparing data from baseline to post-treatment for each subject. TRFLP analysis revealed a high subject to subject variation in the baseline faecal microbiota. The most common antibiotic-induced disturbance was a relative increase in Clostridium , Eubacterium , Bacteroides and Enterobacteraceae . The mean similarity to the baseline increased over time in both treatment groups, although the probiotic group was less disturbed according to both TRFLP and culture data. The culture method revealed that post-antibiotic faecal microbiota in probiotic-consuming subjects were more similar to the baseline microbiota than the control group ( P =0.046). Changes in Enterobactereaceae ( P =0.006) and Bifidobacterium ( P =0.030) counts were significantly different between the groups. Analysis of TRFLP data reinforced the trend between groups but was not statistically significant ( P =0.066). This study indicates this mixture of probiotics promotes a more rapid return to pre-antibiotic baseline faecal bacterial microbiota. Abbreviations: MANOVA, multivariate ANOVA; TRF, terminal restriction fragment; TRFLP, terminal restriction fragment length polymorphism.