Probiotic approach to prevent antibiotic resistance

Abstract

Probiotics are live microorganisms, mainly belonging to the genera Lactobacillus and Bifidobacterium, although also strain of other species are commercialized, that have a beneficial effect on the host. From the perspective of antibiotic use, probiotics have been observed to reduce the risk of certain infectious disease such as certain types of diarrhea and respiratory tract infection. This may be accompanied with a reduced need of antibiotics for secondary infections. Antibiotics tend to be effective against most common diseases, but increasingly resistance is being observed among pathogens. Probiotics are specifically selected to not contribute to the spread of antibiotic resistance and not carry transferable antibiotic resistance. Concomitant use of probiotics with antibiotics has been observed to reduce the incidence, duration and/or severity of antibiotic-associated diarrhea. This contributes to better adherence to the antibiotic prescription and thereby reduces the evolution of resistance. To what extent probiotics directly reduce the spread of antibiotic resistance is still much under investigation; but maintaining a balanced microbiota during antibiotic use may certainly provide opportunities for reducing the spread of resistances. Key messages Probiotics may reduce the risk for certain infectious diseases and thereby reduce the need for antibiotics. Probiotics may reduce the risk for antibiotic-associated diarrhea Probiotics do not contribute to the spread of antibiotic resistance and may even reduce it.

Susceptibility to antibiotics in isolates of Lactobacillus plantarum RAPD‐type Lp299v, harvested from antibiotic treated, critically ill patients after administration of probiotics

“…Selective decontamination has been applied for many years and has been considered not to carry any risk of development of resistant bacteria, although modern techniques have disproved that assumption (Buelow, Bello González, & Verslius, ; Buelow et al., ). In contrast the use of probiotics has appeared as a complement in the prevention of emergence of antibiotic resistance (Ouwehand, Forssten, Hibberd, Lyra, & Stahl, ).…”

“…In contrast the use of probiotics has appeared as a complement in the prevention of emergence of antibiotic resistance (Ouwehand, Forssten, Hibberd, Lyra, & Stahl, 2016). use of probiotics as a complement in restoring a microbial balance has provided promising results.…”

Rebuilding the Gut Microbiota Ecosystem

“…In recent years, thanks to their safety and effectiveness, probiotics were included not only in dairy products but also in nondairy foods such as fruit juices and cereals [87]. Several recent studies have focused on the utilization of probiotics to prevent antibiotic-associated diarrhea, to limit the use of antibiotics, and to consequently reduce the spread of antibiotic-resistant strains [98,99]. The key messages from these studies are (i) a confirmation that the administration of probiotics helps minimize the prevalence and severity of infectious diseases (as a consequence of the implementation of antimicrobial immune responses and of the general health of the individual); (ii) their specific ability to rebalance the gut microbiota permits their use as the sole treatment in many cases of intestinal disorders, thus significantly reducing the prescription of antibiotics; (iii) even when antibiotics are necessary, the co-administration of probiotics reduces the duration of treatment; (iv) the reduced prescription of antibiotics is certainly potentially associated with a reduced spread of antibiotic resistance, although this is not easy to demonstrate.…”

Prevalence of Antibiotic Resistance Genes among Human Gut-Derived Bifidobacteria

“…In fact, bacteria have counteracted the action of antibiotics through the acquisition of a specific genetic arsenal, also known as the resistome, which is involved in inactivation and/or removal of antibiotics. A large part of the resistome is contained within chromosomal DNA, although it may also be present on extrachromosomal replicons like plasmids and phages, which are transmissible to other members of the gut microbiota through horizontal gene transfer (HGT) events (5). Furthermore, antibiotic resistance may also be provided by a mutation in a gene encoding the antibiotic target, in which case the acquired resistance is not considered to be horizontally transferable (5).…”

“…A large part of the resistome is contained within chromosomal DNA, although it may also be present on extrachromosomal replicons like plasmids and phages, which are transmissible to other members of the gut microbiota through horizontal gene transfer (HGT) events (5). Furthermore, antibiotic resistance may also be provided by a mutation in a gene encoding the antibiotic target, in which case the acquired resistance is not considered to be horizontally transferable (5). Antibiotic treatment selects for antimicrobialresistant bacteria, where this selection is positively correlated with antibiotic usage (6).…”