August 5, 2009

Study: Probiotic Drink Failed to Prevent Diarrhea in Most Kids on Antibiotics

Kefir, one of the world's oldest "health" drinks, did little to prevent diarrhea in young children being treated with antibiotics, according to researchers at Georgetown University Medical Center (GUMC). Kefir, which originated in Europe and Asia, is a fermented milk drink that is believed to keep the stomach and immune system strong and stable.

"We were initially interested in this study because many physicians are already recommending yogurts, kefirs, and probiotics [live bacteria] supplements to prevent diarrhea associated with use of antibiotics," the study's lead author, Daniel J. Merenstein, MD, director of research in the Department of Family Medicine at GUMC, was quoted as saying.
Children are especially susceptible to this problem, added Merenstein. About 20 to 30 percent of kids using antibiotics will develop diarrhea from the antibiotic, with the result that they stop taking the antibiotic and miss follow-up visits to the doctor.

"This study didn't prove the benefit of kefir in these children . . . but the results also suggest that kefir may work best in younger, sicker children," Merenstein said. "More studies with this particular group of children are warranted."

Merenstein and colleagues conducted a clinical trial in which 125 children, ages one through five, being treated with antibiotics, were given either a kefir drink to use with their antibiotic tablet each day for 10 days or a placebo drink of kefir in which the probiotics had been destroyed by heat. None of the study coordinators, the children, or their parents knew which drink was given to which participant until the study ended.

Researchers found that 18 percent of children in the kefir group developed diarrhea compared to 22 percent in the placebo group "“ which is not a statistically significant difference. However, in children whose health was poorer at enrollment, 23 percent in the kefir group developed diarrhea, compared with 31 percent in the placebo group.
"Our theory is that kefir may not have helped healthy children that much because the extra immune system boost provided by the drink may not be necessary," said Merenstein. "It is possible, looking at our data, that [the kefir we used] may have some benefit in specific groups. We have found with our other studies that in very healthy children the benefit of probiotics may be minute and difficult to elicit in small studies. That is why we need new larger studies in children to elicit who might benefit."

SOURCE: Archives of Pediatrics and Adolescent Medicine, August 3, 2009