More probiotics and fewer antibiotics, will it ever be possible? A meta-analysis published on 14.9.18 in the European Journal of Public Health offers useful insights for policy makers who can grasp it.
Antibiotics and antibiotic resistance, humans and animals
The World Health Organization adopted a global plan in May 2015 to manage the problem of antibiotic resistance. With the goal of ensuring the prevention and treatment of infectious diseases with safe and effective drugs. (1)
‘
Antibiotics
are drugs used to prevent and treat bacterial infections.
Antibiotic resistance
occurs when bacteria change in response to the use of these drugs. Bacteria, not humans or animals, become resistant to antibiotics‘ (WHO, World Health Organization).
The scale of the problem is offered across the Atlantic by the CDC(Center for Disease Control and Prevention). According to the U.S. health agency, about 2 million cases of antibiotic-resistant bacteria infections occur in the United States each year, resulting in 23,000 deaths.
Reducing antibiotic use is therefore a shared planetary need. Noting that their overuse contributes to antibiotic resistance, health administrations recommend preventing their abuse. Avoiding their use, for example, for viral diseases such as colds, flu and other acute respiratory infections.
WHO then recommended the reduction of the use of these drugs in the livestock supply chain. In fact, the Guidelines published in November 2017 show that the total consumption of essential antibiotics in medicine in some countries is taken up by animal husbandry in a significant proportion, up to 80 percent. (2)
Probiotics and health
Probiotics are live microorganisms that, where administered in appropriate amounts and timing (at least one billion per day 3-4 weeks), can provide various benefits to human health. Originally used for the prevention and treatment of gastrointestinal diseases, probiotics have revealed the ability to strengthen the structure and function of the intestinal barrier, and thus of the immune system.
Scientific evidence cited in the study under review also suggests the ability of probiotic supplementation to reduce the incidence and severity of common infectious diseases, including respiratory tract infections and diarrhea. (3) Thus, the use of probiotic supplements could come associated with reduced antibiotic use.
Probiotics, the meta-analysis
The meta-analysis by Sarah King and collaborators, published in the European Journal of Public Health, considered the impact of supplementation with probiotics, compared with antibiotic use. In cases of acute infections–of the respiratory tract, lower digestive tract, or acute otitis media–on (otherwise) healthy individuals of all ages.
The systematic review of randomized controlled trials included infants, children, adolescents, adults, and the elderly from any country and setting, clinical or nonclinical. Infections eligible for the study included acute respiratory tract infections (i.e., cold, flu, sinusitis, pharyngitis, acute bronchitis, pneumonia), acute otitis media, and acute lower digestive tract infections (diarrhea). Not also gastrointestinal symptoms associated with antibiotics.
Studies were included that evaluated any probiotic strain taken orally, alone or in combination with another probiotic strain. For a duration ranging from 4 days to 9 months (longer than one month in most cases). Compared with placebo or without treatment.
Infants and children who received probiotics containing Lactobacillus and Bifidobacterium, in the form of supplements and food products, were found to be 29% less likely to receive antibiotic treatment.
Probiotic supplementation reduced the incidence of common infectious diseases, including respiratory tract infections and diarrhea. It is also associated with reducing the duration of symptoms in children and adults prone to upper respiratory tract infections.
By reducing the occurrence, duration and/or severity of common acute infections, probiotic administration could therefore come to be considered as a useful strategy to reduce the need for antibiotics. And thus help manage the health emergency of antibiotic resistance.
Dario Dongo and Carlotta Suardi
Notes
(1) General news about antibiotic resistance and WHO/WHO plan at.
http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
(2) Cf.
WHO guidelines on use of medically important antimicrobials in food-producing animals.
, at
http://www.who.int/foodsafety/areas_work/antimicrobial-resistance/cia_guidelines/en/
3) Sarah King, Daniel Tancredi, Irene Lenoir-Wijnkoop, Kelsie Gould, Hailey Vann, Grant Connors, Mary Ellen Sanders, Jeffrey A Linder, Andi L Shane, Dan Merenstein; Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysis
,
European Journal of Public Health
,
https://doi.org/10.1093/eurpub/cky185
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Nutritionist biologist, ADA II level master at the University of Milan Bicocca. External lecturer at LUNEX University, Luxembourg.
