Antibiotics, Your Gut, and BB12
Antibiotics are important medicines, and most of us have needed them or even been saved by them at some point in our lives. Since their discovery, many infectious diseases that were once considered to not just be dangerous, but deadly, have been tamed to the point that they constitute a very small risk to humanity. However, while they fight harmful bacteria, they can also disturb the delicate balance of friendly microbes that live in your gut. Not all antibiotics are targeted, and many or even most of them can kill a broad spectrum of bacteria, not just the ones that are causing you problems, and some of the bacteria effected are often the good guys. This is where Bifidobacterium animalis subsp. lactis BB-12® has a good backing of research that suggests it can help to keep things balanced during treatment, and mitigate the unwanted side effects.
The most common side effect that has been studied here is AAD, or Antibiotic Associated Diarrhoea. In several clinical studies, people who took BB-12® alongside other bacteria during or after a course of antibiotics experienced gentler digestive changes, shorter bouts of loose stools, and a faster return to normal gut balance compared to those who took a placebo.
It doesn’t replace the antibiotics themselves but rather works alongside them. It’s been shown to help the gut bounce back more smoothly afterward. To boot, these studies are all randomised control trials, ensuring the highest standards in clinical human research.
What the Research Shows
Probiotics have been studied in many trials for their effects on antibiotic associated side effects, especially diarrhoea, and BB12 is at the forefront of these studies. The results speak for themselves, so here’s just a few to think about.
One RCT gave participants on antibiotics a probiotic blend of BB12 and a Lactobacillus for 14 days. The overall rate of diarrhoea in the probiotic grouped dropped to 10.8% compared to the 15.6% in the placebo, a significant reduction in risk. But the really interesting results were the duration and severity. The duration of AAD dropped to approximately only 2 days compared to the average 4 days in the placebo group, a drop of 50%. Not only this, but only 31.6% reported watery stools in comparison to a much higher 96% in the placebo. So while both groups had some side effects from the antibiotics, the group taking the probiotics recovered much faster, and the symptoms they experienced were much less severe and short lived.
This result is reflected across multiple studies. Another similar study in hospitalised adults found an AAD rate of only 5.9% AAD in the probiotic group compared to 27.6% in the placebo. Again, a strong indicator that BB12 helped to reduce this unwanted side effect.
A third interesting study took a blend of LGG and BB12, the two bacteria we use, with the addition of LA5, and monitored its effectiveness in children. The results found that not a single child in the probiotic group got severe diarrhoea, compared to 6 in the placebo. And even for minor diarrhoea, only 1 child experienced it with the probiotics, compared to a much higher 21 children in the placebo. This highlights an important point, that whilst these bacteria we study are powerful in and of themselves, together they can have a much more resounding effect. LGG and BB12 clearly make a good team!
The overall pattern here is clear, BB12 has shown an ability time and again to help reduce the rate at which AAD has impacted people of various ages on antibiotic treatments. Not only this, but when AAD has occurred, it’s been less severe, and its duration has been significantly reduced. These are promising results for a side effect that nobody wants, from a medication that sometimes we really need.
So how does this affect me?
Anyone who’s taken antibiotics knows that they can sometimes leave the digestive system feeling disrupted or uncomfortable. Shifts in the human gut flora can bring all sorts of changes, and can have all sorts of side effects, and so when bacteria are directly killed off by antibiotics it stands to reason that people can feel the effects of that. Antibiotics don’t just target the harmful bacteria, they can also impact the beneficial ones that help keep things running smoothly, so mitigating this effect is a good idea.
The research on BB-12® shows that it helps the gut regain its balance more quickly, lessens discomfort, and reduces how long disturbances last. In other words, it helps your system find its rhythm again naturally. This is important, as once bacteria have been killed off it can be very hard to get them back without directly adding them, leading to some people experiencing long term side effects.
For those on antibiotics treating a serious infection, perhaps it’s time to consider reinforcing your microbiome alongside your course. Many official bodies in the world of medicine have already recognised and even recommend probiotics alongside antibiotics! For more info on that, see our AAD article on LGG.
Whilst the results here are pretty amazing, it’s important to remember, it’s always wise to talk to your healthcare practitioner before starting a supplement, especially starting it alongside an existing medication.
References (the science) – Don’t just take our word for it:
1. Chatterjee, S., Kar, P., Das, T., Ray, S., Ganguly, S., Rajendiran, C. and Mitra, M. (2013) ‘Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5® and Bifidobacterium BB-12® for prevention of antibiotic-associated diarrhoea’, Journal of the Association of Physicians of India, 61(10), pp. 708–712. Available at: https://pubmed.ncbi.nlm.nih.gov/24772726/
2. Wenus, C., Goll, R., Loken, E.B., Biong, A.S., Halvorsen, D.S., Florholmen, J. and Paulsen, E. (2008) ‘Prevention of antibiotic-associated diarrhoea by a fermented probiotic milk drink’, European Journal of Clinical Nutrition, 62(2), pp. 299–301. Available at: https://pubmed.ncbi.nlm.nih.gov/17356555/
3. Fox, M.J., Ahuja, K.D.K., Robertson, I.K., Ball, M.J. and Eri, R.D. (2015) ‘Can probiotic yoghurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study’, BMJ Open, 5(1), e006474. Available at: https://pubmed.ncbi.nlm.nih.gov/25588782/
4. de Vrese, M., Kristen, H., Rautenberg, P., Laue, C. and Schrezenmeir, J. (2011) ‘Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity’, Journal of Dairy Research, 78(4), pp. 396–403. Available at: https://pubmed.ncbi.nlm.nih.gov/21871144/
5. Merenstein, D., Grier, A., Turner, K., et al. (2021) ‘Bifidobacterium animalis subsp. lactis BB-12 protects against antibiotic-induced functional and compositional changes in human fecal microbiome’, Nutrients, 13(8), 2814. Available at: https://pubmed.ncbi.nlm.nih.gov/34444974
6. Velasco, M., Brito, D., Martins, D., et al. (2018) ‘Probiotic yogurt for the prevention of antibiotic-associated diarrhea in adults: a randomized double-blind placebo-controlled trial’, Journal of Clinical Gastroenterology, 53(10), pp. 717–723. Available at: https://pubmed.ncbi.nlm.nih.gov/30439760/
7. Merenstein, D.J., Foster, J., D’Amico, F., et al. (2015) ‘Safety of Bifidobacterium animalis subsp. lactis strain BB-12-supplemented yogurt in healthy adults on antibiotics: a phase I safety study’, Gut Microbes, 6(1), pp. 66–77. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4615198/
