Effects of probiotics and antibiotics on the intestinal homeostasis in a computer controlled model of the large intestine

Compared to controls and combination therapy, short chain fatty acids and lactate, but also ammonia and branched chain fatty acids, were increased under probiotic therapy. The metabolic pattern under combined therapy with antibiotics and probiotics had the most beneficial and consistent effect on intestinal metabolic profiles. The intestinal microbiota showed a decrease in several indigenous bacterial groups under antibiotic therapy, there was no significant recovery of these groups when the antibiotic therapy was followed by administration of probiotics. Simultaneous application of anti- and probiotics had a stabilizing effect on the intestinal microbiota with increased bifidobacteria and lactobacilli.Administration of VSL#3 parallel with the clindamycin therapy had a beneficial and stabilizing effect on the intestinal metabolic homeostasis by decreasing toxic metabolites and protecting the endogenic microbiota from destruction. Probiotics could be a reasonable strategy in prevention of antibiotic associated disturbances of the intestinal homeostasis and disorders.Antibiotic-associated diarrhea (AAD) and Clostridium difficile infection (CDI) are frequent complications of broad-spectrum antibiotic therapy. In a large prospective multicenter study, AAD was observed in 4.9% of the patients (1.8%-6.9%) receiving long-term antibiotic treatment with > 50% of patients showing positive testing for C. difficile toxin B [1]. The incidence of CDI is still increasing [2,3] and the disease is complicated by the occurrence of virulent and pathogenic C. difficile ribotypes associated with higher morbidity and mortality, which are responsible for CDI outbreaks worldwide [4]. The increasing incidence and mortality associated with the CDI and the significant rate of treatment failures and recurrences with current antibiotics emphasize the role of preventative strategies.Probiotics are promising agents in the prevention of AAD and CDI. Originally they were used in the therapy of AAD