Health

What you need to know about antibiotic-associated diarrhea


Diarrhea is one of the common side effects of antibiotics, which can lead to intestinal pathology.

Antibiotic abuse and its consequences

The use of antibiotics is like a double-edged sword. In addition to the effectiveness of treatment to kill pathogenic bacteria, antibiotics also cause many side effects, the most common is intestinal microflora disturbances manifested through digestive disorders such as abdominal pain, nausea, diarrhea. .. In which, antibiotic-associated diarrhea is an acute form of diarrhea that may occur in 5-30% of patients, with the incidence increasing as the antibiotic spectrum is increasingly broad.

Children are more prone to diarrhea when taking antibiotics than adults, because their digestive systems are not yet fully developed. According to statistics, in Vietnam, one out of every five children using antibiotics has diarrhea (rate of 20%).

Indiscriminate use of antibiotics will cause many serious consequences. Photo: Shutterstock

There are multiple mechanisms of antibiotic diarrhea. A few antibiotics cause increased intestinal motility, causing fluid and undigested food to be quickly pushed from the intestine to the anus, not through the process of absorption into the body, causing diarrhea, usually mild. Meanwhile, most antibiotics will affect bacteria that cause disturbances in the intestinal microflora, causing diarrhea. Some drugs include both mechanisms, especially the amoxicillin group, which combines with clavulanic acid to make diarrhea worse than others.

The gut microbiome is also closely related to the body’s immune system, helping to maintain a barrier against disease risks. Therefore, when the intestinal microflora is disturbed due to the use of antibiotics, the body’s resistance also decreases. This is the reason why when using too many antibiotics, the body is more susceptible to bacterial infections.

The arbitrary use of antibiotics also causes many other side effects on the body such as allergies, toxicity to the liver, kidneys, anaphylaxis, which can be life-threatening. In the long term, overuse will lead to resistance to antibiotics, which limits the effectiveness of treatment, reduces the effectiveness of the drug in killing bacteria, worsens the disease, and can lead to death.

Most antibiotics can cause diarrhea, but some are more likely to cause diarrhea than others such as cephalosporins, clindamycin, and penicillin.

How do antibiotics affect the gut microbiota?

The human gut microbiota, in addition to beneficial and harmful bacteria, also contains viruses, fungi, and parasites that live naturally in the body.

Normally, the microorganisms in the intestinal tract will exist in a certain balance ratio. When affected by factors such as antibiotic use, dietary changes or disease, the existing balance will be changed in quantity, reducing the diversity of bacterial species, leading to a disorder of the intestinal microflora (also known as dysbiosis in English). Some studies have shown that antibiotic-associated disturbances in the gut microbiota may persist, detectable up to 6 months after antibiotic discontinuation.

Not only expressed through diarrhea, antibiotic-associated intestinal microflora disorders also cause many long-term diseases.

Not only expressed through diarrhea, antibiotic-associated intestinal microflora disorders also cause many long-term diseases. Photo: Shutterstock

The long-term and abusive use of antibiotics will make the microflora in the gut not recover in time, leading to a chronic disorder that is difficult to recover. This can contribute to the development of intestinal conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), or systemic diseases such as obesity, type 2 diabetes, metabolic disease. Alzheimer’s neurodegenerative disease. Children may experience asthma, allergies, immune diseases… These diseases often follow for life with high treatment costs, severely affecting the patient’s quality of life.

Vietnam is in the group of countries with the highest rate of antibiotic resistance.

Vietnam is in the group of countries with the highest rate of antibiotic resistance. Photo: Proceedings of the National Academy of Sciences of the United States of America.

The World Health Organization (WHO) puts Vietnam in the group of countries with the highest rate of antibiotic resistance in the world. Map Antibiotic use in 2015 of IMS Health also showed that Vietnam belongs to the group of countries that use a lot of antibiotics.

While many developed countries still use 1st generation antibiotics effectively, Vietnam has to use 3rd and 4th generation antibiotics. More worryingly, our country has appeared some super bacteria resistant to all antibiotics. The most common group of intestinal gram-negative bacteria.

The solution contributes to the prevention of antibiotic-associated diarrhea and the restoration of intestinal microflora disorders

According to the World Health Organization (WHO), Probiotics (commonly known as probiotics) are live microorganisms that, when added in sufficient quantities, will bring health benefits to the user. Probiotics are found in some foods, supplements, or as medicine for the prevention or treatment of certain diseases related to disorders of the intestinal microflora.

Supplementing with Probiotics helps to restore intestinal microflora, which is considered an effective solution in the treatment of antibiotic-associated diarrhea.

Supplementing with Probiotics helps to restore intestinal microflora, which is considered an effective solution in the treatment of antibiotic-associated diarrhea.

Although probiotics are considered an effective solution in the prevention of antibiotic-associated diarrhea, not all types can maximize this effect. Specifically, based on the study “Antibiotic susceptibility of probiotic strains (Neut C, et al clinical study 2017), the majority of spores such as Bacillus clausii, or live strains of bacteria such as Lactobacillus acidophilus, Bifidobacterium bifidum are killed by prescription antibiotics, so they should be taken at intervals from the antibiotic being used.

Currently, on the market, there is a fungus used as a probiotic that contributes to the prevention of antibiotic-associated diarrhea, which is Saccharomyces boulardii CNCM I-745 manufactured by Biocodex, France. This is a probiotic that can be used with other antibiotics without needing to be dosed apart, and contributes to the treatment, antibiotic as well as the prevention of antibiotic-associated diarrhea.

Le Nguyen

Things to know about antibiotic-associated diarrhea - 4

Bioflora 100 mg, circulation registration number VN-16392-13. Bioflora 200 mg circulation registration number VN-16393-13.

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