With the arrival of the cold season, bacterial infections increase and therefore the use of antibiotics, which can alter the normal intestinal balance. Especially children and the elderly are at risk. It is therefore better to follow a " probiotic diet ", which includes the consumption of probiotics to be used not only during – but also before and after – taking antibiotics. The usefulness of this approach is confirmed by research recently published in the British Medical Journal, which evaluated the effects of consuming fermented milk containing Lactobacillus casei on a population over 50. The temperature drops, the risks of bronchitis, ear infections and all other bacterial infections typical of the winter season. And the massive use of antibiotics begins, often taken even when they are not needed, or in the case of viral infections. According to OsMed (National Observatory on the use of medicines), with its latest National Report on the use of medicines, antibiotics are in fifth place among the classes of medicines most frequently taken by Italians. The antibiotic, the data from the OsMed Report reveal, is a seasonal drug, the peak of consumption is reached when the colder seasons arrive. It is in fact with the arrival of winter ailments that the number of prescriptions increases. And, unfortunately, the cases of antibiotic-related diarrhea and, more generally, of alterations of the intestinal bacterial flora due to the activity of these drugs on the bacteria present in the digestive tract are also on the rise. According to experts, the first rule is to take antibiotics only when necessary. "It must be the doctor who decides whether to start an antibiotic therapy – says Professor Anna Tagliabue, professor of Human Nutrition at the University of Pavia – particularly in the flu forms, which are of viral origin, it is almost never necessary to resort to these medications unless there are complications.” To underline the need not to abuse antibiotics there are also the recent Guidelines of the Istituto Superiore di Sanità on flu syndromes, according to which their use can also be harmful by exposing one to useless risks such as nausea and diarrhea and favoring the phenomenon of resistance. However, when the antibiotic is used to destroy bacteria, it is important to minimize the risk of undesirable effects, such as diarrhea, which is more frequent in patients with weak immune defenses such as children and the elderly. This problem, which is more common in the hospital, usually occurs after antibiotics have finished. The "probiotic" diet: the diet enriched with probiotics Several clinical studies have shown that adding fermented milk enriched with Lactobacillus casei to the normal diet is effective in reducing the risk of antibiotic-induced diarrhea. “A recent work published in the British Medical Journal demonstrated, on a population of over 50, a significant reduction in diarrhea if fermented milk with probiotics (Lactobacillus casei DN-114001, Streptococcus thermophilus and Lactobacillus bulgaricus) is consumed both during and after the period of taking antibiotics, says Professor Tagliabue. The addition of a fermented milk with probiotics – whose effectiveness is documented – in reducing the risk of diarrhea from antibiotics has a dual role: to safeguard intestinal balance and possible gastrointestinal complications, but also to maintain a nutrient supply of the milk in a more assimilable form, since the presence of lactic ferments makes the milk sugar (lactose) digestible. "In the case of febrile infectious disease treated with antibiotics, it will also be appropriate to choose easily digestible and welcome foods, giving preference to fresh fruit or vegetable juices and smoothies rich in vitamins and liquids, lean meats and fish cooked with low fat, pasta or rice seasoned with oil and parmesan. Even some simple sweets (without creams or chocolate) can be allowed to help maintain a good calorie intake. It is better to temporarily reduce whole foods and legumes which, being rich in fiber, can favor intestinal disorders” adds Professor Tagliabue. During the period of taking antibiotics it is therefore necessary to have a careful and balanced diet capable of supplying not only the nutritional principles but also a more than sufficient quantity of vitamins during those infectious diseases which require the use of antibiotics. “Vitamin supplementation for short-term therapies does not seem to be necessary, while integration with probiotics is more useful to reduce the risk of diarrhea” concludes Professor Tagliabue. What is the origin of antibiotic diarrhea? “Antibiotics – explains prof. Lorenzo Morelli, Microbiologist at the University of Piacenza – contrast the pathogenic action of a more or less broad spectrum of bacteria. If on the one hand they intervene against the bacteria responsible for the infection, on the other they can sometimes also act against the "good" microorganisms, which regulate and maintain the balance of the flora". Some types of antibiotics, therefore, can cause diarrhea: this is why it is advisable to follow a diet that favors the balance of intestinal flora. "Probiotics – continues Morelli – are able to maintain the natural balance of the intestine or, if altered, to bring it back to its original state" . And in the child? A diet enriched with probiotics has been shown, also in the literature, to be effective in reducing the risk of diarrhea episodes even in the pediatric population. "Probiotics are fundamental allies to rebalance the bacterial flora of children, because they strengthen the body's natural defenses, contributing to the maintenance of health", asserts Filippo Salvini, pediatric infectious disease specialist at the Pediatric Clinic of the University of Milan – San Paolo “Their effectiveness is supported by several clinical studies. As regards the efficacy of Lactobacillus casei DN-114001, in particular, a French study conducted, during the winter period, on 287 children between 3 and 36 months of life, demonstrated that a daily consumption of L. casei in a fermented milk can reduce diarrhea episodes by 50 percent, compared to children who, on the other hand, consume only milk. Another French study, which involved 928 children aged between 6 and 24 months, proved that the efficacy of L. casei in a fermented milk is higher than that of a normal yogurt in reducing the forms of diarrhea caused by rotavirus, which causes more common viral gastroenteritis among infants and children under 5 years of age” .
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