Prevention of Traveler's Diarrhea while Crossing the Amazon Rainforest by Bike with a Supplement Based on Lacticaseibacillus Rhamnosus LR04 (DSM 16605) + Streptococcus Thermophilus FP4 (DSM 18616) + Bifidobacterium Brevis BR03 (DSM 16604): a Phase Tw

Traveler's diarrhea is a common gastrointestinal illness experienced by individuals traveling to countries with inadequate sanitation and hygiene standards. In this Phase Two, Randomized, Placebo-controlled, Double-blind, Cross-over Pilot Study, we aimed to explore whether a probiotic containing Lacticaseibacillus rhamnosus LR04 (DSM 16605) + Streptococcus thermophilus FP4 (DSM 18616) + Bifidobacterium breve BR03 (DSM 16604) could prevent traveler’s diarrhea and improve quality of life over three months of follow-up in a cohort of athletes biking though the Amazon rainforest. In this pilot study including 3 cyclists randomly assigned to one of the two experimental groups (one probiotic, one placebo). The three participants were men aged 47, 63, 64 years. During the follow-up period, we observed one episode of diarrhea in the probiotic group and one in placebo (p=1.00). However, the number of days with diarrhea was only two in the active group and seven in the placebo group (p=0.33). No episodes of severe diarrhea were observed during the follow-up. At the end of the study, the active group showed a higher quality of life, but no statistically significant. In conclusion, our study suggests that the supplementation with Lacticaseibacillus rhamnosus LR04 (DSM 16605) + Streptococcus thermophilus FP4 (DSM 18616) + Bifidobacterium breve BR03 (DSM 16604) may help prevent traveler’s diarrhea in extreme conditions such as to biking through the Amazon rainforest. However, future larger studies involving a more general population are needed to confirm our findings.