Are probiotics effective to prevent development of C. diff. in patients taking antibiotics and if so, which patients receive the most benefit?

Bottom line:  There is evidence that administering prophylactic probiotics in patients on antibiotics can reduce the risk of C. diff infection without increasing the risk of adverse events.  Probiotics will definitely benefit patients at high-risk for developing Cdiff.

SummaryJohnston BC, et al. Ann Intern Med. 2012 Dec 18;157(12):878-88. Probiotics for the prevention of Clostridium difficile-associated diarrhea: a systematic review and meta-analysis.

This systematic review assessed RCTs including adult and pediatric patients on antibiotics if the study compared any strain or dose of probiotic with placebo or not treatment and measured incidence of C diff associated diarrhea.  RESULTS:  Forest plot pooling CDAD incidence in both groups (Fig. 1) favors the probiotic group (RR, 0.34, 95% CI: 0.24-0.49). Relative risk for adverse events (Fig. 2) showed no difference between the groups (RR, 0.82, 95% CI: 0.65-1.05).

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About Amy

Clinical Informationist at EUH Branch Library
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