Could probiotics each day keep antibiotic prescriptions at bay?

28 FEB 2017 |

Let’s say you have a cold—and it’s a bad one. Your head constantly aches, your nose runs, and you cough until you almost choke. You can’t get warm, no matter how many blankets you wrap around yourself. Five days into this misery you’re exhausted and just want to resume your normal life.

A massive temptation exists at this stage: to visit your doctor and ask for a prescription for antibiotics. In fact, the common cold—officially diagnosed as an upper respiratory tract infection (URTI)—is one of the top reasons for doctors’ visits in the US.

But here’s the problem: antibiotics are ineffective against the common cold. Despite the fact that patients with a URTI frequently ask doctors for antibiotics, and the fact that doctors frequently prescribe them, the common cold is caused by a virus and cannot be cured with drugs that target bacteria. (If the antibiotics appear to work in the end, it might be due to the placebo effect.)

Antibiotics for the common cold account for some of the estimated 30% of all antibiotic prescriptions in US clinics and hospitals that are given inappropriately. Excessive antibiotic use is considered a major threat to global public health, contributing the problem of antibiotic resistance: microorganisms developing the ability to withstand the effects of drugs that are supposed to kill them. Furthermore, antibiotics may affect individuals’ gut microbiota in a way that poses risks to long-term health.

Can all of this be avoided? Ideally, you wouldn’t get a cold in the first place. But it seems impossible to avoid harmful viral exposure in a world that includes regular encounters with public transit, elevator buttons, ATM keypads, or even regular old doorknobs.

A group of scientists and experts are starting to investigate a tool that might solve this tricky problem: probiotics as a preventative measure against the common cold.

A 2015 scientific analysis showed growing evidence for probiotics as a way to improve outcomes related to the common cold. The analysis, which compared groups of adults that used probiotics to those not using probiotics, found 11 fewer people out of 100 developed a cold when probiotics were in the picture. The length of the illness was shorter for those who consumed probiotics, by an average of 2 days. And most importantly: those who took probiotics preventatively had fewer antibiotic prescriptions.

The real-life benefits of using probiotics to prevent the common cold were illustrated by some number-crunching on the populations of France and Canada. Analyses published in 2015 and 2016 showed that widespread consumption of probiotics might save thousands of antibiotic prescriptions per year in each country—between 291,000 and 473,000 in France and between 52,000 and 84,000 in Canada. As a bonus, it could also lead to significant savings on healthcare costs.

Experts from the International Scientific Association for Probiotics and Prebiotics (ISAPP) say they are planning to follow up on this work by systematically investigating the question of whether antibiotic use is reduced when people are given probiotics to prevent or treat infections like the common cold.

Reducing misuse and overuse of antibiotics is an urgent mandate in healthcare, according to the World Health Organization. With more and more evidence, healthcare professionals will understand the most effective way to leverage probiotics for addressing this problem. Because it would be mighty nice to find a way of stopping the shivering, sniffling misery of the person standing next to you in the elevator before it even begins.


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