PRO-ANTIBIOTICS: PROBIOTICS FOR CONCURRENT USE WITH ANTIBIOTICS AND SUPPORTING THERAPY

The Impact of Antibiotic Therapy

Antibiotics, while essential for eliminating pathogenic bacteria responsible for infections, act indiscriminately, also targeting commensal bacteria that help maintain the delicate balance of our gut microbiota. This often leads to a condition known as dysbiosis, a term describing an imbalance in the composition and function of the microbiota. Dysbiosis is not only a consequence of the elimination of beneficial bacteria but also opens the door to a host of associated problems.

The reduction in microbial diversity makes the gut more vulnerable to the overgrowth of Gram-negative bacteria, which can thrive without competition from commensal bacteria. This imbalance promotes symptoms like diarrhea and increases the risk of colonization by opportunistic pathogens such as Clostridioides difficile, which can cause severe infections, especially in already weakened individuals.

Moreover, intestinal dysbiosis can have a broader impact on overall health, increasing the host’s susceptibility to new infections and compromising the efficacy of the intestinal barrier. These consequences highlight how antibiotic use, while indispensable in many therapies, can have significant side effects on the gut microbiota and overall health. Counteracting antibiotic-induced dysbiosis thus becomes a clinical priority, paving the way for new strategies based on the advanced use of “precision” probiotics.

From Probiotics to Pro-Antibiotics

In this context, “pro-antibiotics” emerge—where the prefix “pro” means “in favor of”—a neologism that underscores how these probiotics are designed to work synergistically with antibiotics rather than being compromised by them. These are probiotic strains resistant to specific antibiotics, with intrinsic and non-transferable resistances, representing an innovative alternative. They help maintain microbiota balance, prevent dysbiosis, and mitigate the main side effects of antibiotics.

PharmExtracta, committed to offering innovative solutions to address everyday clinical challenges, is actively involved in researching new probiotics to use in synergy with antibiotic therapies. Bifidobacterium breve PRL2020, present in Brevicillin®, is an emblematic example. Its resistance to the antibiotics amoxicillin and amoxicillin with clavulanic acid makes it an ideal ally for those undergoing treatment with these antibiotics. To learn more about this strain, its properties, and its benefits, explore the detailed information provided in this section.

Other Probiotics Supporting Antibiotic Therapies

Bowell®: Bifidobacterium longum W11

Bowell® contains Bifidobacterium longum W11, the first and only strain with intrinsic and non-transferable resistance to rifaximin. This feature makes it the ideal probiotic for use alongside this antibiotic to maintain gut microbiota balance and reduce the potential risks of antibiotic-associated dysbiosis.

A 2016 clinical study (Graziano et al.) found that Bifidobacterium longum W11 combined with rifaximin reduced the severity of IBS-related intestinal symptoms compared to a group treated with the antibiotic alone.

Another 2019 study (Di Pierro et al.) confirmed that Bowell® is particularly beneficial for patients treated with rifaximin in conditions such as symptomatic uncomplicated diverticular disease (SUDD). The combination of Bowell® and rifaximin improves therapy adherence, reduces treatment duration, and offers superior clinical benefits compared to the antibiotic alone or the sequential use of antibiotic and probiotic.

Crispact®: Lactobacillus crispatus M247

Lactobacillus crispatus M247, contained in Crispact®, is a probiotic notable for its non-transferable resistance to metronidazole. This strain is particularly effective in restoring vaginal microbiota thanks to its ability to adhere to vaginal cells. Additionally, it helps counter and prevent vaginal infections from various origins by producing hydrogen peroxide, a crucial defense against pathogens such as Gardnerella vaginalis, Chlamydia trachomatis, and Trichomonas vaginalis, limiting the proliferation of potentially harmful microorganisms.

Clinical studies validate its potential against HPV infections and its support for the success of assisted reproduction techniques. Its ability to survive in acidic environments, such as those created by boric acid, also makes it suitable for combined use with this antifungal therapy. Crispact® is therefore an excellent solution for maintaining and promoting vaginal microbiota balance, whether used alone, in combination with metronidazole, or during antifungal treatments.

For more details about Crispact®, visit the official website: www.crispact.it

Butirrisan®: Clostridium butyricum CBM588®

Clostridium butyricum CBM588®, present in Butirrisan®, is a unique probiotic capable of producing butyrate, a key metabolite for gut barrier health and integrity. This anaerobic and spore-forming strain can adapt under antibiotic pressure: while its germinating phase is sensitive to most antibiotics, in its spore form, it exhibits resistance, enabling it to survive regardless of the antibiotic used.

Thanks to this characteristic, CBM588® is particularly useful in preventing antibiotic-induced dysbiosis, effectively countering damage caused by antibiotic therapy. Once it reaches the colon, it germinates, proliferates, and produces butyrate. This makes it a valuable ally in reducing inflammation, preventing antibiotic-associated diarrhea, and supporting gut health recovery.

Numerous studies have tested the use of Clostridium butyricum CBM588®. One study, in particular, highlights its potential to reduce antibiotic-induced diarrhea, confirming this probiotic as a valid support tool for various antibiotic therapies, including penicillins, cephalosporins, tetracyclines, and fosfomycins.

For more information on Butirrisan®, visit the official website: www.butirrisan.it.

From Probiotics to Pro-Antibiotics: A New Era for the Microbiota

The era of pro-antibiotics marks a significant innovation in addressing antibiotic-induced dysbiosis. Products such as Brevicillin®, Bowell®, Butirrisan®, and Crispact® offer specific and safe solutions for maintaining gut microbiota balance, even during antibiotic use. Using antibiotic-resistant probiotic strains allows the prevention of common antibiotic therapy side effects like dysbiosis, improving treatment efficacy and supporting microbiota recovery.

Key Takeaways:

1. Antibiotics can cause significant dysbiosis, reducing gut microbiota diversity and damaging the intestinal barrier.
2. Using antibiotic-resistant probiotics offers a strategy to mitigate these side effects, maintaining microbiota balance during antibiotic therapy.
3. Probiotic strain selection must be targeted based on the antibiotic used to maximize efficacy and minimize risks.

Pro-antibiotic probiotics such as Brevicillin®, Bowell®, Butirrisan®, and Crispact® are essential allies for protecting gut microbiota while enhancing the safety and efficacy of antibiotic therapies.