Probiotics in the Prevention and Management of Antibiotic-Resistant Infections

Mahdi Marzi; Ayşe Karacalı Tunç

doi:10.56061/fbujohs.1817657

EN TR

Probiotics in the Prevention and Management of Antibiotic-Resistant Infections

Abstract

Antimicrobial resistance (AMR) represents one of the most critical global health threats of the twenty-first century, responsible for more than one million deaths annually and projected to cause ten million by 2050. The overuse and misuse of antibiotics in human medicine, veterinary practice, and agriculture have accelerated the emergence of multidrug-resistant (MDR) pathogens, severely limiting therapeutic options—particularly in intensive care and oncology settings. In this narrative review, we aimed to integrate mechanistic, translational, and clinical evidence on the preventive and therapeutic roles of probiotics in combating antibiotic-resistant infections. Peer-reviewed literature from 2010 to 2025 was analyzed to summarize current knowledge on molecular mechanisms, clinical efficacy, safety, and regulatory frameworks. Probiotics act through multiple complementary pathways, including competitive exclusion of pathogens, production of antimicrobial metabolites, reinforcement of epithelial-barrier integrity, modulation of immune responses, and disruption of biofilm formation. Randomized clinical trials demonstrate that specific strains—such as Saccharomyces boulardii, Lactobacillus rhamnosus GG, and Bifidobacterium longum—reduce the incidence of antibiotic-associated diarrhea, Clostridioides difficile infection, ventilator-associated pneumonia, and urinary tract infections caused by MDR organisms. Meta-analyses further confirm their role in restoring gut microbial diversity following antibiotic therapy. Probiotics, postbiotics, and next-generation microbiome therapeutics hold significant promise as adjunctive strategies within antimicrobial-resistance management. Their integration into One Health-based antimicrobial-stewardship and precision-medicine frameworks may help restore long-term microbiome equilibrium and reduce global antibiotic dependence.

Keywords

Antibiyotik Dirençli Enfeksiyonların Önlenmesi ve Yönetiminde Probiyotikler

Abstract

Antimikrobiyal direnç (AMR), yirmi birinci yüzyılın en ciddi küresel sağlık tehditlerinden birini temsil etmektedir. Her yıl bir milyondan fazla ölüme neden olmakta ve 2050 yılına kadar bu sayının on milyona ulaşacağı öngörülmektedir. İnsan tıbbında, veteriner uygulamalarda ve tarımda antibiyotiklerin aşırı ve yanlış kullanımı, çoklu ilaç direncine sahip (MDR) patojenlerin ortaya çıkışını hızlandırmış; bu durum özellikle yoğun bakım ve onkoloji alanlarında tedavi seçeneklerini ciddi biçimde kısıtlamıştır. Bu anlatı derlemede, antibiyotiğe dirençli enfeksiyonlarla mücadelede probiyotiklerin önleyici ve tedavi edici rollerine ilişkin mekanistik, translasyonel ve klinik kanıtları bütünleştirmeyi amaçladık. 2010–2025 yılları arasındaki hakemli literatür incelenerek moleküler mekanizmalar, klinik etkinlik, güvenlilik ve düzenleyici çerçeveler hakkındaki güncel bilgiler özetlenmiştir. Probiyotikler; patojenlerin rekabetçi dışlanması, antimikrobiyal metabolitlerin üretimi, epitel bariyer bütünlüğünün güçlendirilmesi, bağışıklık yanıtlarının düzenlenmesi ve biyofilm oluşumunun engellenmesi gibi çoklu ve birbirini tamamlayan yollarla etki gösterir. Randomize klinik çalışmalar, Saccharomyces boulardii, Lactobacillus rhamnosus GG ve Bifidobacterium longum gibi belirli suşların; antibiyotik ilişkili ishal, Clostridioides difficile enfeksiyonu, ventilatörle ilişkili pnömoni ve çoklu ilaç dirençli mikroorganizmaların neden olduğu idrar yolu enfeksiyonlarının görülme sıklığını azalttığını göstermektedir. Meta-analizler, ayrıca antibiyotik tedavisini takiben bağırsak mikrobiyota çeşitliliğinin yeniden sağlanmasında bu mikroorganizmaların rolünü doğrulamaktadır. Probiyotikler, postbiyotikler ve yeni nesil mikrobiyom temelli tedaviler, antimikrobiyal direnç yönetimi kapsamında tamamlayıcı stratejiler olarak önemli bir potansiyel taşımaktadır. Bu yaklaşımların, Tek Sağlık (One Health) temelli antimikrobiyal gözetim ve hassas tıp (precision medicine) çerçevelerine entegre edilmesi, uzun vadede mikrobiyom dengesinin yeniden kurulmasına ve küresel antibiyotik bağımlılığının azaltılmasına katkı sağlayabilir.

Keywords

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Details

Primary Language

English

Subjects

Pharmaceutical Microbiology

Journal Section

Review

Authors

Mahdi Marzi ^*
0000-0002-8518-0818
Türkiye

Ayşe Karacalı Tunç
0000-0002-6453-9887
Türkiye

Publication Date

May 20, 2026

Submission Date

November 4, 2025

Acceptance Date

December 2, 2025

Published in Issue

Year 2026 Volume: 6 Number: 1

DOI

https://doi.org/10.56061/fbujohs.1817657

IZ

https://izlik.org/JA69JL84RS

Cite

RIS / Bibtex

APA

Marzi, M., & Karacalı Tunç, A. (2026). Probiotics in the Prevention and Management of Antibiotic-Resistant Infections. Fenerbahçe University Journal of Health Sciences, 6(1). https://doi.org/10.56061/fbujohs.1817657

AMA

1.Marzi M, Karacalı Tunç A. Probiotics in the Prevention and Management of Antibiotic-Resistant Infections. FBU-JOHS. 2026;6(1). doi:10.56061/fbujohs.1817657

Chicago

Marzi, Mahdi, and Ayşe Karacalı Tunç. 2026. “Probiotics in the Prevention and Management of Antibiotic-Resistant Infections”. Fenerbahçe University Journal of Health Sciences 6 (1). https://doi.org/10.56061/fbujohs.1817657.

EndNote

Marzi M, Karacalı Tunç A (May 1, 2026) Probiotics in the Prevention and Management of Antibiotic-Resistant Infections. Fenerbahçe University Journal of Health Sciences 6 1

IEEE

[1]M. Marzi and A. Karacalı Tunç, “Probiotics in the Prevention and Management of Antibiotic-Resistant Infections”, FBU-JOHS, vol. 6, no. 1, May 2026, doi: 10.56061/fbujohs.1817657.

ISNAD

Marzi, Mahdi - Karacalı Tunç, Ayşe. “Probiotics in the Prevention and Management of Antibiotic-Resistant Infections”. Fenerbahçe University Journal of Health Sciences 6/1 (May 1, 2026). https://doi.org/10.56061/fbujohs.1817657.

JAMA

1.Marzi M, Karacalı Tunç A. Probiotics in the Prevention and Management of Antibiotic-Resistant Infections. FBU-JOHS. 2026;6. doi:10.56061/fbujohs.1817657.

MLA

Marzi, Mahdi, and Ayşe Karacalı Tunç. “Probiotics in the Prevention and Management of Antibiotic-Resistant Infections”. Fenerbahçe University Journal of Health Sciences, vol. 6, no. 1, May 2026, doi:10.56061/fbujohs.1817657.

Vancouver

1.Mahdi Marzi, Ayşe Karacalı Tunç. Probiotics in the Prevention and Management of Antibiotic-Resistant Infections. FBU-JOHS. 2026 May 1;6(1). doi:10.56061/fbujohs.1817657