***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Antibiotic-associated diarrhea ( AAD ) is a common complication of antibiotic use . There is growing interest in probiotics for the treatment of AAD and Clostridium difficile infection because of the wide availability of probiotics . The aim of this multicenter , r and omized , placebo-controlled , double-blind trial was to assess the efficacy of probiotic Lactobacillus ( Lacidofil ® cap ) for the prevention of AAD in adults . From September 2008 to November 2009 , a total of 214 patients with respiratory tract infection who had begun receiving antibiotics were r and omized to receive Lactobacillus ( Lacidofil ® cap ) or placebo for 14 days . Patients recorded bowel frequency and stool consistency daily for 14 days . The primary outcome was the proportion of patients who developed AAD within 14 days of enrollment . AAD developed in 4 ( 3.9 % ) of 103 patients in the Lactobacillus group and in 8 ( 7.2 % ) of 111 patients in the placebo group ( P=0.44 ) . However , the Lactobacillus group showed lower change in bowel frequency and consistency ( 50/103 , 48.5 % ) than the placebo group ( 35/111 , 31.5 % ) ( P=0.01 ) . Although the Lacidofil ® cap does not reduce the rate of occurrence of AAD in adult patients with respiratory tract infection who have taken antibiotics , the Lactobacillus group maintains their bowel habits to a greater extent than the placebo group Objective : The impact on mood and memory of consuming a probiotic containing milk drink , or a placebo , was examined as , previously , a poor mood has been found to correlate with the frequency of constipation . Design : A double-blind placebo-controlled trial with r and om allocation of subjects . Setting : Subjects went about their normal life in the community apart from three visits to the laboratory . Subjects : One hundred and thirty-two healthy members of general population , mean age 61.8 years , volunteered in response to local media coverage . One hundred and twenty-four finished the trial . Intervention : For a 3-week period , either a probiotic containing milk drink , or a placebo , were consumed daily . Mood and cognition were measured at baseline , and after 10 and 20 days of consumption . Results : At baseline those who reported themselves to be less frequently constipated were more clearheaded , confident and elated . Although the taking of the probiotic did not generally change the mood , this appeared to be a reflection of the generally good mood in this sample . When those in the bottom third of the depressed/elated dimension at baseline were considered , they selectively responded by reporting themselves as happy rather than depressed after taking the probiotic . The intervention did not , however , influence the reported frequency of defaecation , probably a reflection of the initially low incidence of constipation . An unexpected and possibly chance finding was that the consumption of probiotics result ed in a slightly-poorer performance on two measures of memory . Conclusions : The consumption of a probiotic-containing yoghurt improved the mood of those whose mood was initially poor . This improvement in mood was not , however , associated with an increased frequency of defaecation . Sponsorship : Funded by Yakult , Japan Probiotics have potential to improve host immunity ; however , there is less evidence showing their efficacy against infections and nutritional status in the elderly . We conducted a double-blinded feeding trial in the elderly to eluci date the effect of fermented milk containing Lactobacillus johnsonii La1 ( LC1 ) on infections and nutritional status . Twenty-four completely enterally fed elderly in- patients aged over 70 years were r and omly assigned into two groups . All subjects were administered 3768 kJ ( 900 kcal)/d of total enteral nutrition ( EN ) through tube feeding for 12 weeks . Subjects in the LC1 group were administered 373 kJ ( 89 kcal)/d of LC1 fermented milk after feeding of 3395 kJ ( 811 kcal)/d of EN for 12 weeks . In the control group , 373 kJ/d of the same EN was replaced from the fermented milk . In the LC1 group , the percentage of days with infections during the run-in observation period was 15.4 ( SD 17.3 ) % , which significantly decreased to 5.7 ( SD 8.1 ) % during the intervention period ( P = 0.018 ) , and the reduction was larger than that of the control group ( P = 0.047 ) . Blood Hb increased ( P < 0.05 ) , and there was a tendency towards an increase in serum albumin and a decrease in TNF-alpha ( a pro-inflammatory cytokine ) in the LC1 group . There was a trend towards an increase in blood phagocytic activity ( a natural immunity marker ) in the subjects whose initial level was low in the LC1 group . There were no changes in those parameters in the control group . Administration of fermented milk containing the probiotic L. johnsonii La1 may contribute to suppressing infections by improving nutritional and immunological status in the elderly Oral intake of Lactobacillus pentosus strain b240 ( b240 ) has been shown to enhance the secretion of salivary secretory IgA in elderly adults . However , its clinical benefits remain to be determined . We tested the hypothesis that b240 exerts a protective effect against the common cold  in elderly adults . The design of the present study was a r and omised , double-blind , placebo-controlled trial ( RCT ) with parallel three-group comparison . For this purpose , 300 eligible elderly adults were r and omly allocated to one of three groups , namely a placebo , low-dose or high-dose b240 group . Participants in the low-dose and high-dose b240 groups were given tablets containing 2 × 10(9 ) or 2 × 10(10 ) cells , respectively , of heat-killed b240 , while those in the placebo group were given tablets without b240 . Each group consumed their respective tablets once daily for 20 weeks . The common cold was assessed on the basis of a diary . Change in quality of life was evaluated using the SF-36 . Of the total participants , 280 completed the 20-week RCT . The accumulated incidence rate of the common cold was 47·3 , 34·8 and 29·0 % for the placebo , low-dose b240 and high-dose b240 groups , respectively ( P for trend = 0·012 ) . Lower incidence rates were consistently observed throughout the experimental period in the b240 groups ( log-rank test , P= 0·034 ) . General health perception , as determined by the SF-36 ® , dose-dependently increased in the b240 groups ( P < 0·025 ) . In conclusion , oral intake of b240 significantly reduced the incidence rate of the common cold in elderly adults , indicating that b240 might be useful in improving resistance against infection through mucosal immunity The low socioeconomic region of Greater Western Sydney ( GWS ) has higher than average rates of gastrointestinal symptoms . The relationship between prescription drug usage and constipation has not been explored . The aim of this study was to investigate the impact of drug use on constipation in the elderly population of GWS ( NSW , Australia ) . A r and om selection of elderly residents completed a postal question naire for constipation and drug use ( response 30.7 % ) . Bivariate associations between constipation and number of drug use and number of drug use with constipation adverse effect were compared . For multivariate analysis multiple logistic regression was performed for constipation with the number of drugs , use of drugs with known constipation side effects , and each drug class ( Anatomical Therapeutic Chemical Classification System ( ATC ) level 4 ) as independent variables . The prevalence of constipation was 33.9 % . There was a dose – response relationship between constipation and the number of drugs used ( odds ratio 1.24 , p < 0.001 ) and the usage of drugs with known constipation adverse effects ( odds ratio 2.21 , p = 0.009 ) . These findings suggest that constipation is associated with the number of drugs used , particularly those with constipation adverse-effects , in the elderly of GWS Background s/ Aims : To clarify the usefulness of Lactobacillus casei strain Shirota (LcS)-fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly . Methods : A r and omized placebo-controlled double-blind test was performed among the elderly residents ( average age , 85 ) and staff members ( average age , 37 ) of facilities for the elderly . The participants r and omly received either LcS-fermented milk or a placebo beverage once daily for 6 months . Clinical data and enteric conditions were compared between the 2 groups . Results : A significantly lower incidence of fever and improved bowel movements were seen in the LcS-fermented milk group ( n = 36 ) in comparison to the placebo group ( n = 36 ) . The numbers of Bifidobacterium and Lactobacillus were significantly higher ( p < 0.01 ) , the numbers of destructive bacteria such as Clostridium difficile were significantly lower ( p < 0.05 ) , and the fecal acetic acid concentration and total acidity were significantly higher in the LcS group . A significant difference in the intestinal microbiota , fecal acetic acid , and pH was also observed between the LcS and placebo groups among the facility 's staff members . Conclusions : The long-term consumption of LcS-fermented milk may be useful for decreasing the daily risk of infection and improving the quality of life among the residents and staff of facilities for the elderly Purpose Elderly people are particularly vulnerable to seasonal influenza . Therefore , vaccination is strongly recommended . However , the vaccine efficacy is lower in the elderly , owing to immunosenescence . The objective of the present study was to evaluate the ability of the probiotic strain Lactobacillus coryniformis K8 CECT5711 to enhance the immune response to the influenza vaccine  in the elderly and to assess the effects on symptoms related to respiratory infections . Methods A r and omized , double-blind , placebo-controlled trial was conducted between November 2015 and April 2016 . A total of 98 nursing home residents , more than 65 years of age were r and omly assigned to receive L. coryniformis K8 CECT5711 ( 3 × 109 CFU/day ) or a placebo for 2 weeks before influenza vaccination . The primary outcome was the percentage of seroconversion . The secondary outcomes were the incidence of influenza-like illness ( ILI ) and respiratory symptoms associated with respiratory infections during the 5-month follow-up period . The serum cytokine and immunoglobulin levels were also evaluated . Results The percentage of responders to vaccination was higher in the probiotic group than in the control group ( p = 0.036 ) . L. coryniformis ingestion was associated with a significantly lower incidence of respiratory symptoms commonly associated with respiratory infections ( p = 0.007 ) and lower consumption of analgesics ( p = 0.008 ) . Conclusion The administration of L. coryniformis K8 CECT5711 to an elderly population  increased the immune response against the influenza vaccine and decreased symptoms associated with respiratory infections . Probiotic administration may be a natural and safe strategy to improve the efficacy of vaccines and to protect against common respiratory infections in susceptible population Objective To determine the impact of probiotics on the prevention of problems with bowel movements malnutrition and infection . Design A r and omized , double-blind , placebo-controlled trial . Setting Peripheral Geriatric Hospital . Participants : 243 elderly patients age≥65y who were hospitalized in a Geriatric Orthopedic Rehabilitation Department . Intervention : Participants were r and omized into treatment or control groups ( daily probiotics or placebo for 45 consecutive days , respectively ) . Measurements The main outcomes were : number of days of constipation or diarrhea and the number of days of laxative use . Secondary measures were nutritional status and blood measurements . Results Of 599 patients admitted to the Geriatric Rehabilitation ward , 345 were eligible and agreed to participate . During a 7-day pre-trial period , 102 patients dropped out ( 45 and 57 in the probiotic and placebo groups respectively ) . Out of the 243 patients who entered the study , 28 dropped out during the study ( 11.5 % ) , leaving 215 patients . Throughout the 45 days of follow-up , the incidence of diarrhea was significantly lower among the study group ( HR=0.42 , p=0.04 ) with a more pronounced difference among participants aged ≥ 80y ( HR=0.32 , p=0.026 ) . Laxative use ( as an indicator of constipation severity ) was significantly lower in the study group compared with the control group ( HR=0.74 , p=0.032 ) . Serum albumin , prealbumin and protein increased significantly more in the treatment group compared with the control group among participants age≥80y ( P=0.047 , p=0.07 , p=0.03 respectively ) but not in the younger age group . Conclusion We showed that probiotic supplements may have a positive effect on bow 
    Output:
    
Conclusions A growing body of research has applied commercially available probiotic preparations across care setting s for age related conditions including gut dysmotility , osteoporosis , common infectious diseases and cognitive impairment .