Not another course of antibiotics!

A friend recently returned from overseas with a prolonged chest infection and was unhappy about having to take a second course of antibiotics. Her doctor had prescribed different antibiotics due to ongoing antibiotic associated diarrhea (AAD), which is commonly associated with antibiotic use. Antibiotics can disturb the gastro-intestinal floras ability to resist pathogen colonization. Treatment with probiotics at some stage of antibiotic treatment is thought to re-inoculate the gut's disturbed micro flora.

This year two different meta-analysis have confirmed earlier results supporting the preventive effects of probiotics in AAD.1The latest meta-analysis of 20 trials involving 3800 people found probiotics were associated with a 66% decrease in the incidence of AAD, which indicates a large protective effect of probiotics in preventing ADD.2

The trial used several probiotics in a variety of doses given at various times during the course of antibiotic administration. It doesn’t seem to matter which probiotic was given or when; the authors state to simply take yoghurt (containing probiotics) with the antibiotic.

My friend’s also upset about urine loss associated with prolonged bouts of coughing. She’s diligently repeating pelvic floor exercises but it’s difficult to gain benefit quickly, with coughing causing repeated internal pressure down on her bladder. Her pelvic floor muscles (PFMs) aren’t strong, so they tire quickly and fail to effectively close the sphincters and support the bladder. Healthy PFMs tighten and lift early to counteract the internal pressure rises: obviously it’s necessary to keep the muscles strong and responsive with regular exercise.

We’re trying some first aid to protect her internal supports and muscles from further strain. Along with using ‘the knack’ (strongly lifting the PFMs before coughing) she’s been fitted with a temporary vaginal pessary ring support to help prevent further collapse of her front vaginal wall. Part of the ring sits up under the bladder neck and in combination with ‘the knack’ is stopping the bladder leaks when she coughs.

This scenario can happen to any woman (my friend doesn’t have babies). Add regular PFM exercises to your daily health routine so your pelvic floor’s able to cope with sudden internal pressure demands.

1.Meta-analysis: probiotics in antibiotic-associated diarrhea

E. J. Videlock, F. Cremonini.Alimentary Pharmacology & Therapeutics

Volume 35, Issue 12, pages 1355–1369, June 2012

2. Probiotics for the Prevention of Clostridium difficile–Associated Diarrhea: A systematic Review and Meta-analysis. Bradley C. Johnston, PhD; Stephanie S. Ma, MD; Joshua Z. Goldenberg, BSc; Kristian Thorlund, PhD; Per O. Vandvik, MD, PhD; Mark Loeb, MD; and Gordon H. Guyatt, M. Ann Intern Med. 13 November, 2012