Department of Food Science and Technology, University of California, Davis, CA, USA.
Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA.
Curr Opin Biotechnol. 2020 Feb;61:226-234. doi: 10.1016/j.copbio.2020.01.005. Epub 2020 Feb 19.
Antibiotic-associated diarrhea (AAD) is a common and unintended adverse effect of antibiotic treatment. It is characterized by the disruption of the gut microbiota, decreased intestinal short chain fatty acid (SCFA) concentrations, accumulation of luminal carbohydrates and colonic bile acids, altered water absorption, and ultimately diarrhea. Probiotics were shown to prevent AAD in numerous clinical trials. This review examines what is currently known about how probiotics reduce the risk for AAD via modulating the gut microbiota, altering nutrient and bile acid metabolism, inducing epithelial solute transporter activity, supporting intestinal barrier function, and influencing the immune system. Although probiotics are frequently prescribed with antibiotic use, mechanistic evidence verifying how they confer protection against AAD is extremely limited. This information is urgently needed for improving recommendations for sustaining probiotic development and for implementing probiotics in clinical settings.
抗生素相关性腹泻（AAD）是抗生素治疗中常见且非预期的不良反应。其特征为肠道微生物群紊乱、肠道短链脂肪酸（SCFA）浓度降低、腔内碳水化合物和结肠胆酸积累、水分吸收改变，最终导致腹泻。大量临床试验表明益生菌可预防 AAD。本综述探讨了益生菌通过调节肠道微生物群、改变营养物质和胆酸代谢、诱导上皮溶质转运体活性、支持肠道屏障功能和影响免疫系统，从而降低 AAD 风险的作用机制。尽管益生菌常与抗生素一起使用，但验证其预防 AAD 的保护机制的机制证据极其有限。急需这些信息来改善益生菌开发的建议，并在临床环境中实施益生菌。
