Winclove’s probiotics found to help prevent antibiotic-associated diarrhea in elderly population

27 May 2021 --- Elderly people, particularly those in care institutes, may stand to benefit from probiotics’ ability to help prevent antibiotic-associated diarrhea (AAD). These individuals often consume antibiotics and are therefore more prone to develop this dysfunction as a side-effect. 

Dutch-headquartered Winclove Probiotics recently conducted a study to gain insight into the opportunities and barriers for implementation of probiotics in elderly healthcare. The company’s probiotic, Ecologic AAD, is backed by this research suggesting it may help alleviate AAD.

Prescribing probiotics as part of a medications list could become common practice and is deemed a responsible course of action by researchers.

“The population above the age of 65 is growing fast every year,” notes the company. “With aging, many complications appear – such as impaired gastrointestinal function and reduced senses of smell and taste – and often lead to malnutrition.”

“The aging process confronts elderly people with complex medical issues associated with a disturbance of the gut microbiota and, as a result, a decline in immune functions. Due to suppressed immune responses, the elderly are more susceptible to infections and the consequences of those infections.”

Fortifying a vulnerable population
AAD is often linked to additional health risks such as malnutrition and dehydration. It is caused by dysbiosis of the intestinal microbiota and the growth of specific pathogens that take the place of the commensal species killed by antibiotics.

Research demonstrates that probiotic use results in fewer AAD episodes among elderly patients in care institutions.

Frequent antibiotic use can increase the risk of colonization with antibiotic-resistant microorganisms. Probiotics are considered one way to restore the intestinal microbiome.

However, probiotics are rarely recommended to elderly people and “poorly implemented” in elderly care institutes, according to Winclove Probiotics.

“It has been estimated that up to 10 percent of nursing home residents are on antibiotic treatment at any moment as a treatment for illnesses ranging from pneumonia to urinary tract infections,” the company details.

“Diarrhea in elderly people also increases the workload of care staff, which places an additional burden of costs on the healthcare system.”

The PrOud study
Winclove Probiotics performed a study in collaboration with Dutch elderly care physicians, dieticians, pharmacists and researchers of the Rivas Zorggroep; the Louis Bolk Institute and the Van Praag Institute.

The study is entitled “Pragmatic evaluation of the implementation of probiotics in elderly care” (PrOud) and designed as a pragmatic participation evaluation. It included 93 nursing home residents with 167 episodes of antibiotic use.

“The study’s strength lies in the fact that we compare the probiotic treatment period with data on antibiotic use recorded for the residents prior to the study, which means that some patients serve as their own control,” notes Winclove Probiotics.

The researchers encourage doctors to give practical, tailored advice on probiotics use in line with antibiotic prescriptions.

In the study, a treatment group of 71 patients received probiotics during a course of antibiotics and a control group of 49 patients did not receive probiotics. The patients in the control group received in total 83 courses of antibiotics, and 36 percent of these patients developed diarrhea.

Meanwhile, 27 patients received antibiotics during the control period (without probiotics), as well as during the intervention test period (with probiotics). 

A total of 84 courses of antibiotics were prescribed in the treatment group. Diarrhea occurred in 20 percent of these cases, which was significantly lower (p=0.022) than in the control group.

Combining medication with holistic therapy
During the control period, 14 of the 27 (52 percent) patients developed AAD after taking antibiotics. In the test period, when patients received probiotics in addition to the antibiotic course, four of the 27 patients (15 percent) suffered from diarrhea. 

More specifically, of those patients with a history of AAD development during the control period, only three of 14 suffered from diarrhea when supplemented with probiotics, which corresponds to a 78 percent reduction.

Two of the 27 patients had up to six to seven antibiotic courses in the test period, in comparison to one or two antibiotic courses when probiotics were taken.

“This suggests that probiotics possibly might have a long-term effect and break the vicious circle of new infections and repeated antibiotic use in care institutes,” notes Winclove Probiotics. “This finding should be elucidated further in follow-up research.”

The PrOud study was recently nominated for the Dutch James Lind Innovation Award, initiated by the NPN, a Dutch industry association. The award has an accompanying grant of €10,000 (US$12,200).

Probiotics market developments
Among recent probiotics market highlights, the term “probiotic” can now be used in Denmark as a mandatory category designation on dietary supplements, following in the footsteps of Poland and the Netherlands.

Daily probiotic use was associated with fewer upper respiratory symptoms in overweight and older people in a recent Gut Microbes-published study. 

Hailed as a “world-first” in probiotics, researchers recently identified the molecule lipoteichoic acid as the compound that may be behind the efficacy of ADM’s Bifidobacterium animalis subsp. lactis CECT 8145 (BPL1).

Edited by Benjamin Ferrer