Two-level combined probiotics – a new paradigm for the prevention of respiratory tract infections and antibiotic-associated conditions | CMAC

Two-level combined probiotics – a new paradigm for the prevention of respiratory tract infections and antibiotic-associated conditions

Clinical Microbiology and Antimicrobial Chemotherapy. 2026; 28(2):171-186

​ Andreeva I.V., Andreev V.A., Dovgan E.V., Karpova E.P., Ovchinnikov A.Yu., Selimzyanova L.R., Stetsiouk O.U.
10.36488/cmac.2026.2.171-186
antibiotic-sparing technologies probiotic probiotic microorganisms Streptococcus salivarius K12 Lacticaseibacillus rhamnosus GG antibiotic-associated conditions respiratory tract infections antibiotic-associated diarrhea
Section
Diseases and Pathogens
Type
Review
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2026; 28(2):171-186

Abstract

In light of the widespread growth of antimicrobial resistance, the decline in the effectiveness of existing antibiotics, and the global shortage of innovative antibacterial drugs, preventing infectious diseases and preserving antibiotics for future generations are more urgent than ever. This is why the medical community is paying more attention to antibiotic-sparing technologies. One such technology involves modulating the gastrointestinal microbiota to influence the immune response using live biotherapeutic products and probiotics. This publication provides a detailed analysis of the properties, effectiveness and safety of using two probiotic strains of normal human microbiota – Streptococcus salivarius K12 (SsK12) and Lacticaseibacillus rhamnosus GG (LGG). Additionally, it explores the potential of a new, two-level probiotic for preventing respiratory tract infections and antibiotic-associated conditions, such as antibiotic-associated diarrhea and oral candidiasis, in real clinical practice.

Irina V. Andreeva

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

Vladislav A. Andreev

Smolensk State Medical University, Smolensk, Russia

Eugeniy V. Dovgan

Smolensk Regional Clinical Hospital, Smolensk, Russia

Karpova E.P.

Russian Medical Academy of Continuous Professional Education, Moscow, Russia

Ovchinnikov A.Yu.

Russian University of Medicine, Moscow, Russia

Selimzyanova L.R.

Research Institute of Pediatrics and Children’s Health at the NCC

Olga U. Stetsiouk

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

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