PhD Scientific Days 2022

Budapest, 6-7 July 2022

Health Sciences (Poster discussion will take place in the Aula during the Coffee Break)

Probiotic supplementation during antibiotic therapy modulates the diversity of gut microbiome – a systematic review and meta-analysis of randomized controlled trials

Éliás A. 1,2, Földvári-Nagy L. 1,3, Simon V. 1, Schnabel T. 10, Patoni C. 1,6, Demeter D. 1, Veres D. 1,9, Bunduc S. 1,5,6,7, Erőss B. 1,4,5, Hegyi P. 1,4,5,8, Lenti K. 1,3

1. Center for Translational Medicine, Semmelweis University
2. Doctoral School of Health Sciences, Semmelweis University
3. Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University
4. Institute for Translational Medicine, Medical School, University of Pécs
5. Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University
6. Carol Davila University of Medicine and Pharmacy
7. Fundeni Clinical Institute, Bucharest
8. János Szentágothai Research Center, University of Pécs
9. Department of Biophysics and Radiation Biology, Semmelweis University
10. ÉKC New Saint John's Hospital, Budapest

Text of the abstract

Introduction: Antibiotics are among the main causes of low-diversity dysbiosis. Probiotics are used to prevent dysbiosis, but the effects of concurrent probiotic supplementation on fecal microbiota composition during antibiotic therapy has not been well established.
Aim: Assessing the effect of concurrent probiotic supplementation on gut microbiota in patients treated with antibiotics.
Method: We performed a systematic review and meta-analysis of randomized controlled trials reporting on the differences in gut microbiome diversity between patients under antibiotherapy who receive concomitant probiotic supplementation and those who receive antibiotics alone. The systematic search was performed on 15 October 2021 through Medline, Embase and CENTRAL databases without filters. The study protocol was registered on PROSPERO (CRD42021282983). The random-effects model estimated pooled mean differences (MD) and 95% confidence intervals.
Results: Out of 11767 articles, we included 15 in the systematic review and 4 in the meta-analysis. Antibiotics indication and posology, probiotics strains, treatment durations, moment of sampling and the method for microbiome diversity evaluation varied across the studies. The Shannon diversity index was significantly higher in the probiotic supplemented group by comparison with the control group when assessed immediately after antibiotherapy (MD=0.33, 95%CI [0.00; 0.66], I2=66% [2%; 89%]). Penury of data prevented us from meta-analyzing other diversity indices. α- and ß-diversity indices are reported as either higher in the intervention group or not significantly different between the groups. Although the affected phyla and genera tend to be similar after the antibiotic treatment between the two groups, the level of changes are larger in the control than in the intervention group. However, these changes are restored to levels similar to baseline in both groups after 3-8 weeks of follow-up.
Conclusion: Our results suggest that probiotic supplementation during antibiotherapy might be able to maintain a more diverse microbiome and reduce the level of changes in the intestinal flora composition, yet the evidence is limited. Standardization of methods for microbiome diversity measurement and definition of its optimal value will allow future studies generating more homogenous data with increased clinical relevance.
Funding: No funding