W1383 The Effect of Two Different Doses of Arabinoxylo-Oligosaccharides and Oligofructose Enriched Inulin On the Colonic Ammonia Metabolism in Healthy Volunteers Lieselotte Cloetens, Joost Van Duppen, Willem F. Broekaert, Christophe M. Courtin, Jan A. Delcour, Paul Rutgeerts, Kristin Verbeke Introduction: Previous studies using the biomarker lactose-[15N,15N]-ureide ( 15 N-LU), a precursor molecule that introduces a known amount of 15 NH 3 in the colon, have shown that prebiotics beneficially influence the colonic ammonia metabolism. They increase the faecal 15 N-excretion while reducing the urinary 15 N-excretion, which indicates a lower colonic generation of ammonia and/or a higher bacterial uptake due to stimulation of bacterial growth and/or activity. In this study, the influence of arabino-oligosaccharides (AXOS, degree of polymerisation = 9, degree of arabinose substitution = 0.25) on the colonic ammonia metabolism was compared to that of oligofructose-enriched inulin (OF-IN). Materials and methods: Two cross-over studies with different doses of AXOS and OF-IN were performed. In the first study, 13 healthy volunteers were administered 5.0g/day AXOS or OF-IN during two weeks with a 3-weeks wash-out period in between. In the second study, 11 healthy volunteers were administered 2.25g/day AXOS and OF-IN. Before, at the start (short term) and immediately after (long term) each intake period, a test meal labelled with 15 N-LU and 3 H-PEG, as an inert marker to measure total gastrointestinal transit, was consumed. After each test meal, a fractionated urine collection (48h) and faeces collection (72h) were per- formed. 15N -enrichment in urine and faeces was measured by combustion-IRMS. Results are expressed as % of the administered dose. Urinary data were corrected for creatinine content. Faecal data were corrected for total transit. Results: After short term intake of 5.0g/ day AXOS or OF-IN, urinary 15 N-excretion was significantly decreased (p= 0.01 and p= 0.03, respectively) as compared to baseline, whereas a significant increase in faecal 15 N- excretion was observed after intake of AXOS (p<0.01) and OF-IN (p<0.01). After long term intake of AXOS, there was a significant decrease in urinary 15 N-excretion (p=0.03). However, urinary 15 N-excretion after long term intake of OF-IN was not influenced. Faecal 15 N- excretion trended to an increase after long term intake of AXOS but remained unchanged after OF-IN treatment. On the other hand, the intake of 2.25g AXOS and OF-IN did not influence urinary and faecal 15 N-excretion after short term intake as well as long term intake. Conclusion: At a dose of 5.0g/day, AXOS beneficially influence the colonic ammonia metabolism in a similar way of OF-IN. W1384 A Randomized Controlled Trial of Lactobacillus GG in Infantile Diarrhea Sudipta Misra, Tapas K. Sabui Results of probiotic use in diarrhea have been mixed. This randomized controlled trial was designed to test the efficacy of lactobacillus GG (LGG) in infantile diarrhea. Methods-Infants with diarrhea, below 36 months of age, admitted at a suburban hospital in West Bengal, India were enrolled. Infants were randomized to receive either LGG (Culturerlle®) or placebo for 10 days. Clinical data was recorded and stool tests were done for up to Day 10 of enrollment and at 6 weeks. Z scores were calculated with WHO Anthro 2005 software. Weight for height Z score was used as an age independent nutritional marker. Descriptive and Wilcoxon Rank-Sum tests were used for statistical analysis. The study was approved by ethics committee. Results:-Two hundred and ten infants were studied, excluding 19 who failed to complete the full course of LGG/placebo. Three were lost on follow-up. LGG and placebo groups were comparable at enrollment except for the infants in the LGG group (n= 105) having lower weight for age Z scores (Table). There was no difference in the clinical course of diarrhea between the two groups (Table). This held true when stratified by rotavirus infection (n=54,25.7%). At 6 weeks follow up, weight for height Z scores increased significantly in the whole population (medians -1.87 initial and -1.56 follow-up, p<.01) and the sub-groups. However, differences of Weight for height Z scores (ΔZ) at enrollment and 6 weeks were not significantly different between LGG and placebo groups (Table). In contrast, ΔZ was significantly lower in children with rotavirus than those without the infection (median 0.08 and 0.27, P=.011). In the LGG group, no difference in clinical outcome was seen between those growing LGG from stool on day 10 (n=23, 21.9%) and those who did not. Conclusion:-We did not document any beneficial effect of LGG in infantile diarrhea irrespect- ive of evidence of gut colonization. This study also confirms our previously reported findings of high incidence of rotavirus in infantile diarrhea and slower nutritional recovery after the infection. Table *ΔZ=Difference in Weight of height Z score between 6 weeks follow up and enrollment. A-693 AGA Abstracts W1385 The Composition of the Dominant Fecal Microbiota in COPD Patients Receiving Multispecies Probiotics During and After Antibiotic Intake Catherina Koning, Daisy Jonkers, Hauke Smidt, Herman-Jan Pennings, Emiel Wouters, Ellen Stobberingh, Reinhold Stockbrugger Introduction Healthy individuals have a unique intestinal microbiota (i.e. genetic fingerprint) that is relatively stable in time. Antibiotic intake is known to cause short-term disturbances in the composition of this microbiota and recently medium and long-term disturbances in specific bacterial populations have been described. Probiotics can affect the composition of the intestinal microbiota beneficially and may prevent/restore such disturbances. However, data in chronically ill patients with a potentially disturbed immune system and an altered intestinal microbiota are limited. Aim and Methods The alterations of the dominant fecal microbiota by antibiotics and the possible prevention/restoration by a multispecies probiotic were studied in patients with chronic obstructive pulmonary disease (COPD) treated with antibiotics for a respiratory tract infection. Five gram of a multispecies probiotic (5 lactobacilli, 3 bifidobacteria, 1 Enterococcus) (10 9 cfu/gr) or placebo was given twice daily for two weeks starting simultaneously with standard antibiotic treatment. From each patient fresh fecal samples were collected at day 0, 7, 14 and 63. Changes in the composition of the dominant fecal microbiota were determined by denaturating gradient gel electrophoresis (DGGE) of PCR-amplified V6-V8 regions of bacterial 16S rRNA genes and expressed as “similarity indices” (SI) between two samples and number of bands within each sample. Results Thirty patients completed the study (17 in the probiotic group, mean age 60 yrs (13.3), and 13 in the placebo group, mean age 63 yrs (7.4)). Patients had a history of extensive antibiotic use (1-7 treatments in previous year). SIs were high and remained stable during and after antibiotic treatment. No effect of probiotic intake was observed. Mean band number was also stable over time, ranging from 14.4-15.4 bands. Conclusion In this COPD population no effect of antibiotics and of subsequent probiotic intake could be observed on the dominant faecal microbiota. Low band numbers and high SIs compared to previous findings in healthy volunteers suggest a narrowed diversity of the dominant faecal microbiota due to extensive prior antibiotic use. This observation may have contributed to the lack of effect by probiotic and antibiotic intake in this COPD population. Table 1: DGGE Similarity indices of the dominant fecal microbiota in % (median (range)) W1386 The Effect of a Multispecies Probiotic On the Composition of the Fecal Microbiota and Bowel Habits in COPD Patients Treated with Antibiotics Catherina Koning, Daisy Jonkers, Linda Tijsseling, Herman-Jan Pennings, Emiel Wouters, Ellen Stobberingh, Reinhold Stockbrugger Introduction In various patient populations it has been demonstrated that antibiotic intake can cause a disturbance of the intestinal microbiota resulting in antibiotic-associated diarrhea, which can be prevented by probiotics. It is widely assumed that disturbances are short- term, but also long-term disturbances have been described. We wanted to study whether a multispecies probiotic can affect bowel habits and quantitative bacterial changes in chronically ill patients with a potentially disturbed immune system and microbiota. Methods Chronic obstructive pulmonary disease (COPD) patients treated with antibiotics for a respiratory tract infection were given 5 gram of a multispecies probiotic (5 lactobacilli, 3 bifidobacteria, 1 Enterococcus) (10 9 cfu/gr) or placebo twice daily for 2 weeks starting with standard antibiotic treatment. Fresh fecal samples were collected at day 0, 7, 14 and 63. Colony forming units (cfu) per gram feces of total aerobic and anaerobic growing bacteria, enterobacteriaceae, enterococci, Bacteroides spp., lactobacilli and yeast were determined by culture. Fecal consist- ency and frequency were scored daily according to the Bristol stool form scale. Results Thirty patients completed the study (17 in the probiotic, mean age 60 yrs (13.3), and 13 in the placebo group, mean age 63 yrs (7.4)). Patients had a history of extensive antibiotic use (1-7 treatments in previous year). After probiotic intake compared to placebo an increase in median fecal enterococci was found at t=14 (7.6 vs 6.3 log cfu/g feces (p<0.05)). In addition, an increase in median total aerobes was found at t=7 days (8.1 vs 7.3 log cfu/g feces (p<0.05)). Moreover, in the probiotic group significant differences were found over time in total aerobes, enterococci, lactobacilli, and Bacteriodes spp. and within the placebo group in enterococci and lactobacilli. No significant difference in the prevalence of diarrhea- like bowel movements (frequency ≥ 3 and/or consistency ≥ 5 for at least 2 days) was observed in the probiotic compared to the placebo group (77% vs 70%). Conclusion Apart from an increase in enterococci and aerobes, no other significant differences were observed in the probiotic compared with the placebo group. However, changes over time were present in both groups, which differed significantly between groups, suggesting a probiotic effect. In contrast to healthy volunteers, no preventive effect of probiotic intake was observed in this population. However, the presence of long-term disturbances of the fecal microbiota due to the extensive prior antibiotic use, may have contributed to the lack of effect in this COPD population. W1387 Efficacy of Probiotics in Treatment of Pediatric Atopic Dermatitis: A Meta- Analysis of Randomized, Controlled Trials Sonia Michail, Gary Onady, Adrienne Stolfi, Thomas Johnson Objective: Several studies examining the efficacy of probiotics in atopic dermatitis have been published. This report discusses a meta-analysis of randomized controlled trials describing the efficacy of probiotics in this disorder. Study design: A comprehensive search was performed of databases from inception to August 2007. Three reviewers independently assessed the studies for methodological qualities. All data were analyzed and forest plots were evaluated for the AGA Abstracts