Lactobacillus casei 用于 抗生素相关性腹泻（AAD）
C 证据 来自小型研究的证据有限，但存在一些积极信号。Some evidence for AAD prevention in hospitalized elderly patients (PLACIDE trial was negative for primary outcome but showed trends).
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C
结论
Some evidence for AAD prevention in hospitalized elderly patients (PLACIDE trial was negative for primary outcome but showed trends).
Key Study Findings
In Vitro
Complex probiotics alleviate ampicillin-induced antibiotic-associated diarrhea in mice.
Dose: 4-strain probiotic mixture
vs: Ampicillin-induced AAD model
Outcome: Gut microbiota recovery and immune modulation
效果: None
None
研究人群: Ampicillin-induced AAD mouse model
Meta-Analysis
n=692
Which probiotic has the best effect on preventing Clostridium difficile-associated diarrhea? A systematic review and …
Dose: None
vs: Control group
Outcome: the incidence rates of AAD and CDAD, and …
效果: OR 0.39,
None
研究人群: Diarrhea patients
Randomized Controlled Trial
n=314
4.3 weeks
Double-blind
Probiotic Yogurt for the Prevention of Antibiotic-associated Diarrhea in Adults: A Randomized Double-blind Placebo-controlled Trial.
Dose: None
vs: Placebo
Outcome: Bowel function
效果: None
p=0.30
研究人群: None
Systematic Review
n=228
Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis.
Dose: None
vs: None
Outcome: Diarrhea outcomes
效果: None
None
研究人群: None
Controlled Clinical Trial
n=32
4.3 weeks
Open-label
Feasibility of a Lactobacillus casei Drink in the Intensive Care Unit for Prevention of Antibiotic …
Dose: 10 billion L. casei, 2 bottles/day
vs: Contemporary matched controls
Outcome: Safety, feasibility, AAD incidence
效果: None
None
研究人群: ICU patients on antibiotics
Meta-Analysis
n=9569
Comparative efficacy and tolerability of probiotics for antibiotic-associated diarrhea: Systematic review with network meta-analysis.
Dose: None
vs: Placebo/no probiotic
Outcome: Prevention of antibiotic-associated diarrhea
效果: LGG OR 0.28 (0.17-0.47) for AAD prevention
None
研究人群: Patients on antibiotics
Key Statistics
3
研究数量
500
受试者
↑
Positive
C
等级
Referenced Papers
Frontiers in microbiology
2023
21 次引用
Journal of digestive …
2020
43 次引用
Journal of clinical …
2019
17 次引用
Frontiers in medicine
2018
450 次引用
United European gastroenterology …
2018
66 次引用
Nutrients
2018
50 次引用
F1000Research
2016
63 次引用
Antibiotics (Basel, Switzerland)
2015
104 次引用
Clinical infectious diseases …
2015
59 次引用
World journal of …
2014
73 次引用
Savings from the use of a probiotic formula in the prophylaxis of antibiotic-associated diarrhea.
Other
Journal of medical …
2012
28 次引用
Revista da Sociedade …
2012
13 次引用
Journal of clinical …
2011
432 次引用
The American journal …
2010
313 次引用
Canadian journal of …
2007
182 次引用
Acta paediatrica Taiwanica …
2004
6 次引用
International journal of …
2000
181 次引用
The Journal of …
1999
559 次引用
Anaerobe
1997
40 次引用
Dosage & Usage
mg = milligrams · mcg = micrograms (1,000× smaller) · IU = International Units
常用剂量
- general:
- 1-10 billion CFU/day
- aadprevention:
- 6.5 billion CFU/day (Shirota strain)
- immunesupport:
- 10 billion CFU/day
上限： Well-tolerated up to 20 billion CFU/day in clinical trials
研究中使用的剂量
| 剂量 | 持续时间 | 效果 | N |
|---|---|---|---|
| 4-strain probiotic mixture | -- | Positive | -- |
| None | -- | Positive | 692 |
| None | 4.3 weeks | Neutral | 314 |
| None | -- | Mixed | 228 |
| 10 billion L. casei, 2 bottles/day | 4.3 weeks | Positive | 32 |
| None | -- | Positive | 9569 |
| None | -- | Mixed | -- |
| None | -- | Positive | -- |
最佳服用时间： With or without food; consistent daily timing recommended
Safety & Side Effects
已报告的副作用
- ⚠ Mild gas and bloating during initial use
- ⚠ Occasional loose stools
- ⚠ Rare dairy-related reactions in lactose-sensitive individuals
- ⚠ Very rare: bacteremia in immunocompromised individuals
已知相互作用
- ● Antibiotics (may reduce probiotic viability; space dosing 2 hours apart)
- ● Immunosuppressants (theoretical risk in immunocompromised patients)
可耐受最高摄入量： Well-tolerated up to 20 billion CFU/day in clinical trials
在开始服用任何补充剂之前，请务必咨询您的医疗保健提供者。
Frequently Asked Questions
Does Lactobacillus casei help with 抗生素相关性腹泻（AAD）?
Based on 3 studies with 500 participants, there is limited but promising evidence that Lactobacillus casei may support 抗生素相关性腹泻（AAD） management. Our evidence grade is C (Some Evidence).
How much Lactobacillus casei should I take for 抗生素相关性腹泻（AAD）?
Studies have used various dosages. A commonly studied range is 1-10 billion CFU/day. Always consult your healthcare provider before starting any supplement regimen.
Are there side effects of Lactobacillus casei?
Reported side effects may include Mild gas and bloating during initial use, Occasional loose stools, Rare dairy-related reactions in lactose-sensitive individuals, Very rare: bacteremia in immunocompromised individuals. Most side effects are mild and dose-dependent. Consult your doctor if you experience any adverse reactions.
How strong is the evidence for Lactobacillus casei and 抗生素相关性腹泻（AAD）?
We rate the evidence as Grade C (Some Evidence). This rating is based on 3 peer-reviewed studies with 500 total participants. The overall direction of effect is positive.
Related Evidence
其他成分用于 抗生素相关性腹泻（AAD）
References
- [1] Wenwen Li et al.. Front Microbiol. 2023. Complex probiotics alleviate ampicillin-induced antibiotic-associated diarrhea in mice. doi:10.3389/fmicb.2023.1156058 PubMed
- [2] Yan Ma et al.. J Dig Dis. 2020. Which probiotic has the best effect on preventing Clostridium difficile-associated diarrhea? A systematic review and network meta-analysis. doi:10.1111/1751-2980.12839 PubMed
- [3] María Velasco et al.. J Clin Gastroenterol. 2019. Probiotic Yogurt for the Prevention of Antibiotic-associated Diarrhea in Adults: A Randomized Double-blind Placebo-controlled Trial. doi:10.1097/MCG.0000000000001131 PubMed
- [4] Lynne V McFarland et al.. Front Med (Lausanne). 2018. Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. doi:10.3389/fmed.2018.00124 PubMed
- [5] Jiayi Cai et al.. United European Gastroenterol J. 2018. Comparative efficacy and tolerability of probiotics for antibiotic-associated diarrhea: Systematic review with network meta-analysis. doi:10.1177/2050640617736987 PubMed
- [6] Cathy Alberda et al.. Nutrients. 2018. Feasibility of a Lactobacillus casei Drink in the Intensive Care Unit for Prevention of Antibiotic Associated Diarrhea and Clostridium difficile. doi:10.3390/nu10050539 PubMed
- [7] Sunit C Singhi et al.. F1000Res. 2016. Probiotics in critically ill children. doi:10.12688/f1000research.7630.1 PubMed
- [8] Lynne V McFarland. Antibiotics (Basel). 2015. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review. doi:10.3390/antibiotics4020160 PubMed
- [9] Julie Auclair et al.. Clin Infect Dis. 2015. Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, and Lactobacillus rhamnosus CLR2 (Bio-K+): Characterization, Manufacture, Mechanisms of Action, and Quality Control of … doi:10.1093/cid/civ179 PubMed
- [10] Christoph G Dietrich et al.. World J Gastroenterol. 2014. Commercially available probiotic drinks containing Lactobacillus casei DN-114001 reduce antibiotic-associated diarrhea. doi:10.3748/wjg.v20.i42.15837 PubMed
- [11] Alvine Adrienne Kamdeu Fansi et al.. J Med Econ. 2012. Savings from the use of a probiotic formula in the prophylaxis of antibiotic-associated diarrhea. doi:10.3111/13696998.2011.629015 PubMed
- [12] Daniela Nogueira Prado de Souza et al.. Rev Soc Bras Med Trop. 2012. The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial. doi:10.1590/s0037-86822012000100021 PubMed
- [13] Stefano Guandalini. J Clin Gastroenterol. 2011. Probiotics for prevention and treatment of diarrhea. doi:10.1097/MCG.0b013e3182257e98 PubMed
- [14] Xing Wang Gao et al.. Am J Gastroenterol. 2010. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium … doi:10.1038/ajg.2010.11 PubMed
- [15] M Beausoleil et al.. Can J Gastroenterol. 2007. Effect of a fermented milk combining Lactobacillus acidophilus Cl1285 and Lactobacillus casei in the prevention of antibiotic-associated diarrhea: a randomized, … doi:10.1155/2007/720205 PubMed
- [16] Yu-Kung Chou et al.. Acta Paediatr Taiwan. 2004. In vitro antibiotic susceptibility of lactobacilli isolated from commercial products containing active lactobacilli. PubMed
- [17] E Bergogne-Bérézin. Int J Antimicrob Agents. 2000. Treatment and prevention of antibiotic associated diarrhea. doi:10.1016/s0924-8579(00)00293-4 PubMed
- [18] J A Vanderhoof et al.. J Pediatr. 1999. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. doi:10.1016/s0022-3476(99)70053-3 PubMed
- [19] L V McFarland et al.. Anaerobe. 1997. Pharmaceutical probiotics for the treatment of anaerobic and other infections. doi:10.1006/anae.1996.0062 PubMed
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