Comparative Effectiveness of Restrictive Antibiotic versus Probiotic-Fluids First Protocols for Adult Diarrhea.

Abstract

Objective: Comparative Effectiveness of Restrictive Antibiotic vs. Probiotic-Fluids First Protocols for Adult Diarrhea.

Methodology: Over a period of one month, a prospective cohort study was carried out. A total of 136 patients with newly diagnosed acute diarrhea, ages 13 to 40, were recruited and split into two groups: Group A received probiotics plus ORS (n = 68) and Group B received antibiotics plus ORS (n = 68). Time to symptom resolution, frequency of bowel movements, related gastrointestinal symptoms, need for supportive therapy, and seven-day ED visits were among the clinical outcomes evaluated.

Results: Compared to the probiotic group, patients receiving antimicrobial treatment showed reduced stool frequency (5 vs. 10 episodes/day), shorter recovery times (mean 5 vs. 8 days), and fewer revisits (35 vs. 40). Additionally, compared to the probiotic group (50 and 45 cases), nausea and vomiting were less common in the antimicrobial group (45 and 30 cases, respectively). Antimicrobials caused constipation more frequently (20 vs. 10 cases). Although the probiotic group experienced a greater number of symptoms, no serious side effects were noted, suggesting that it may be useful in treating simple, self-limiting diarrhea.

Conclusion: Probiotic-plus-ORS therapy served as a safe, non-antibiotic option for mild cases, aligning with antimicrobial stewardship goals. Conversely, antimicrobial-plus-ORS therapy led to quicker recovery and fewer revisits, stressing the importance of prudent antibiotic use and the need for randomized trials to strengthen non-antibiotic treatments for acute diarrhea.

Keywords: Anti-Bacterial Agents, Antimicrobial Stewardship, Diarrhea, Oral Rehydration Solutions, Probiotics, Treatment Outcome.