Cannizzaro S, Maiorani C, Scribante A, Butera A. Personalized Treatment of Periodontitis in a Patient with McArdle's Disease: The Benefits from Probiotics. Case Rep Dent. 2023;

Costa-Pinto AR, Lemos AL, Tavaria FK, Pintado M. Chitosan and Hydroxyapatite Based Biomaterials to Circumvent Periprosthetic Joint Infections. Materials. 2021; 14

ECDC. Antimicrobial resistance surveillance in Europe: 2021 data. 2023. http//

Garaiova I, Paduchova Z, Nagyova Z Probiotics with vitamin C for the prevention of upper respiratory tract symptoms in children aged 3-10 years: randomised controlled trial. Benef Microbes. 2021; 12:(5)431-440

Garaiova I, Paduchova Z, Nagyova Z Probiotics with low dose vitamin C reduce antibiotic prescriptions in children: A secondary analysis of a multicentre randomised double-blind placebo-controlled trial. J Funct Foods. 2023; 106

Lobanovska M, Pilla G. Penicillin's Discovery, and Antibiotic Resistance: Lessons for the Future?. Yale J Biol Med. 2017; 90:135-145

Schwenger EM, Tejani AM, Loewen PS. Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev. 2015;

Sihra N, Goodman A, Zakri R Nonantibiotic prevention and management of recurrent urinary tract infection. Nat Rev Urol. 2018; 15:(12)750-776

Probiotics and antibiotics

02 November 2023
Volume 5 · Issue 11


While promoting antibiotic stewardship, alternative antibiotic-free approaches to bacterial infections are being explored, including the use of probiotics, says George Winter

By 1945, with penicillin heralding the dawn of antibiotic therapy, Sir Alexander Fleming had warned ‘that the high public demand of antibiotics would determine an “era of abuse”; this eventually became a reality’ (Lobanovska and Pilla, 2017). Further confirmation came this year when the European Centre for Disease Prevention and Control (ECDC) reported that data for 2021 from the World Health Organization's European Region showed that ‘33% of the countries reported resistance percentages of 25% or higher in K. pneumoniae. Carbapenem resistance was also common in Pseudomonas aeruginosa and Acinetobacter species, and at a higher percentage than in K. pneumoniae’ (ECDC, 2023).

To mitigate such challenges while promoting antibiotic stewardship, alternative antibiotic-free approaches to bacterial infections are being explored. For example, Costa-Pinta et al (2021), in addressing prosthetic joint infection involving implanted prostheses – often necessitating prosthetic removal and antibiotic administration – consider the introduction of natural antimicrobial compounds like chitosan into prostheses: ‘Chitosan is a potential valuable biomaterial presenting properties such as biocompatibility, biodegradability, low immunogenicity, wound healing ability, antimicrobial activity, and anti-inflammatory potential.’

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