{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:46:29Z","timestamp":1783529189875,"version":"3.55.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recent or ongoing use of antibiotics causes diarrhea. Probiotic yogurt is generally used in antibiotic-induced diarrhea as adjuvant therapy. In recent times, there have been no clear recommendations or guidelines for the course of treatment of probiotics in preventing antibiotic-induced diarrhea in infants and young children in mainland China. The objectives of the study were to evaluate the efficacy and safety of <jats:italic>Saccharomyces boulardii<\/jats:italic> and <jats:italic>Bifidobacterium<\/jats:italic> in antibiotic-induced diarrhea in infants and young children in Chinese settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected retrospectively. Infants and children received antibiotic treatments with 50 g daily regular yogurt and 50 g daily regular yogurt for 7 days after those treatments (AY cohort, <jats:italic>n<\/jats:italic> = 119), or with 10 billion CFU daily <jats:italic>Saccharomyces boulardii<\/jats:italic> and 10 billion CFU daily <jats:italic>Saccharomyces boulardii<\/jats:italic> for 7 days after those treatments (AS cohort, <jats:italic>n<\/jats:italic> = 110), or with 10 billion CFU daily <jats:italic>Bifidobacterium<\/jats:italic> and 10 billion CFU daily <jats:italic>Bifidobacterium<\/jats:italic> for 7 days after those treatments (AB cohort, <jats:italic>n<\/jats:italic> = 106). Two times per day loose or watery stools were considered mild diarrhea, and three or more times per day loose or watery stools were considered severe diarrhea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All infants and young children reported diarrhea after the start of any type of antibiotic treatment with probiotics. Time for the start of diarrhea after the start of antibiotic treatments with probiotics was higher in infants and children of the AS cohort than in infants and children of the AY [3 (4\u20133) days <jats:italic>versus<\/jats:italic> 1 (1\u20131) days, <jats:italic>p<\/jats:italic> &amp;lt; 0.001] and the AB [3 (4\u20133) days <jats:italic>versus<\/jats:italic> 2 (2\u20131) days, <jats:italic>p<\/jats:italic> &amp;lt; 0.001] cohorts. Twenty-four (20%), 11 (10%), and 17 (16%) infants and children reported any type of diarrhea in the AY, AS, and AB cohorts, respectively. The number of patients with reported diarrhea (mild and severe) and the number of patients who required extra anti-diarrheal treatments after antibiotic treatments in the AS cohort were fewer than those reported in the AY and the AB cohorts (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 for all). Yogurt reported sneezing, runny nose, redness of the eyes, and nausea in the AY cohort (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 for all comparisons). <jats:italic>Saccharomyces boulardii<\/jats:italic> and <jats:italic>Bifidobacterium<\/jats:italic> caused vomiting and nausea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Any type of antibiotic treatment cause diarrhea in infants and young children. Probiotics especially <jats:italic>Saccharomyces boulardii<\/jats:italic> co-treatments with any type of antibiotic treatment, significantly reduce incidences of diarrhea in infants and young children with manageable adverse effects.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1575605","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T04:10:42Z","timestamp":1750738242000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Saccharomyces boulardii and Bifidobacterium co-treatment for antibiotic associated diarrhea in pediatrics: a multicenter efficacy and safety study"],"prefix":"10.3389","volume":"15","author":[{"given":"Qianfang","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusong","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2270","DOI":"10.22207\/JPAM.16.4.19","article-title":"Lactobacillus species as probiotics: Isolation sources and health benefits","volume":"16","author":"Al-Yami","year":"2022","journal-title":"J. Pure Appl. Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1038\/s41579-023-00936-9","article-title":"Antibiotic-induced collateral damage to the microbiota and associated infections","volume":"21","author":"de Nies","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2014-006474","article-title":"Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study","volume":"5","author":"Fox","year":"2015","journal-title":"BMJ Open"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/14651858.CD004827.pub5","article-title":"Probiotics for the prevention of pediatric antibiotic-associated diarrhea","volume":"4","author":"Guo","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/MD.0000000000016873","article-title":"Definitive BCG immunotherapy versus radical cystectomy in intermediate or high-risk nonmuscle invasive bladder cancer patients: A retrospective study","volume":"98","author":"Jian","year":"2019","journal-title":"Medicine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cyto.2019.154791","article-title":"Modulation of 5-fluorouracil activation of toll-like\/MyD88\/NF-\u03baB\/MAPK pathway by Saccharomyces boulardii CNCM I-745 probiotic","volume":"125","author":"Justino","year":"2020","journal-title":"Cytokine"},{"key":"B7","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/imr.2017.279.issue-1","article-title":"The intestinal microbiota: Antibiotics, colonization resistance, and enteric pathogens","volume":"279","author":"Kim","year":"2017","journal-title":"Immunol. Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2718","DOI":"10.13699\/j.cnki.1001-6821.2023.18.028","article-title":"Evaluation of the pharmaceutical properties of Bifidobacterium tetravalent viable tablets","volume":"39","author":"Li","year":"2023","journal-title":"Chin. J. Clin. Pharmacol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu13124319","article-title":"Which probiotic is the most effective for treating acute diarrhea in children? A Bayesian network meta-analysis of randomized controlled trials","volume":"13","author":"Li","year":"2021","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1001\/jamapediatrics.2022.1973","article-title":"Multispecies probiotic for the prevention of antibiotic-associated diarrhea in children: A randomized clinical trial","volume":"176","author":"Lukasik","year":"2022","journal-title":"JAMA Pediatr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.copbio.2020.01.005","article-title":"Molecular mechanisms of probiotic prevention of antibiotic-associated diarrhea","volume":"61","author":"Mekonnen","year":"2020","journal-title":"Curr. Opin. Biotechnol."},{"key":"B12","first-page":"415","article-title":"Advice on pediatric prescription pre-checking of microecological preparations","volume":"37","year":"2022","journal-title":"Chin. J. Pract. Pediatr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3168\/jds.2020-19116","article-title":"Invited review: Probiotic yogurt quality criteria, regulatory framework, clinical evidence, and analytical aspects","volume":"104","author":"Nyanzi","year":"2021","journal-title":"J. Dairy Sci."},{"key":"B14","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3748\/wjg.v29.i1.19","article-title":"Microbiota of the gastrointestinal tract: Friend or foe","volume":"29","author":"Senchukova","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/MPG.0000000000003633","article-title":"Probiotics for the management of pediatric gastrointestinal disorders: Position paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications","volume":"76","author":"Szajewska","year":"2023","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1097\/MCG.0000000000001131","article-title":"Probiotic yogurt for the prevention of antibiotic-associated diarrhea in adults: A randomized double-blind placebo-controlled trial","volume":"53","author":"Velasco","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s13312-022-2557-7","article-title":"Indian Academy of Pediatrics Consensus Guidelines for probiotic use in childhood diarrhea","volume":"59","author":"Yachha","year":"2022","journal-title":"Indian Pediatr."},{"key":"B18","first-page":"823","article-title":"Clinical comprehensive evaluation of probiotics in preventing antibiotic-associated diarrhea in children","volume":"23","author":"Yuncui","year":"2020","journal-title":"Pract. Drugs Clinics"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fcimb.2022.924119","article-title":"The complex link and disease between the gut microbiome and the immune system in infants","volume":"12","author":"Zhang","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.7499\/j.issn.1008-8830.2401129","article-title":"A prospective randomized controlled study on probiotics for the prevention of antibiotic-associated diarrhea in infants and young children","volume":"26","author":"Zhang","year":"2024","journal-title":"Chin. J. Contemp. Pediatr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"424","DOI":"10.3760\/cma.j.cn101070-20210201-00137","article-title":"Expert consensus on diagnosis, treatment and prevention of antibiotic-associated diarrhea in children","volume":"36","author":"Zheng","year":"2021","journal-title":"Chin. J. Pract. Pediatr."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1575605\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T04:10:46Z","timestamp":1750738246000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1575605\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":21,"alternative-id":["10.3389\/fcimb.2025.1575605"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1575605","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"article-number":"1575605"}}