antibiotics Review Potential Roles for Probiotics in the Treatment of COVID-19 Patients and Prevention of Complications Associated with Increased Antibiotic Use Ravina Kullar 1,*, Stuart Johnson 2, Lynne V. McFarland 3 and Ellie J. C. Goldstein 4 1 Expert Stewardship, Inc., 320 Superior Avenue, Newport Beach, CA 92663, USA 2 Hines VA Hospital and Loyola University Medical Center, Chicago, IL 60141, USA;
[email protected] 3 Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA;
[email protected] 4 RM Alden Research Laboratory and the David Geffen School of Medicine at UCLA, Los Angeles, CA 90230, USA;
[email protected] * Correspondence:
[email protected] Abstract: Medical care for patients hospitalized with COVID-19 is an evolving process. Most COVID-19 inpatients (58–95%) received empiric antibiotics to prevent the increased mortality due to ventilator-associated pneumonia and other secondary infections observed in COVID-19 patients. The expected consequences of increased antibiotic use include antibiotic-associated diarrhea (AAD) and Clostridioides difficile infections (CDI). We reviewed the literature (January 2020–March 2021) to explore strategies to reduce these consequences. Antimicrobial stewardship programs were effective in controlling antibiotic use during past influenza epidemics and have also been shown to reduce healthcare-associated rates of CDI. Another potential strategy is the use of specific strains of Citation: Kullar, R.; Johnson, S.; probiotics shown to be effective for the prevention of AAD and CDI prior to the pandemic. During McFarland, L.V.; Goldstein, E.J.C. Potential Roles for Probiotics in the 2020, there was a paucity of published trials using these two strategies in COVID-19 patients, but Treatment of COVID-19 Patients and trials are currently ongoing.