Probiotics and antibiotics?

I recently saw Leon, a three-year-old boy with acute otitis media.

As I was writing the prescription for amoxycillin, I remembered that there was a recent Australian study published on using yoghurt to prevent antibiotic-associated diarrhoea in children.1

The last time I asked the question in adults in 2013, the evidence was unclear.2

So, what about for kids?

CLINICAL QUESTION

Does consuming probiotic yoghurt reduce the risk of developing diarrhoea in children taking oral antibiotics?

What does the existing research evidence say?

Step 1: The Cochrane Library

The Cochrane Library contains a 2011 systematic review for “probiotics” (not necessarily yoghurt) in preventing antibiotic-associated diarrhoea in children. Although there was a suggestion of a protective effect, the