Ms Mary Hickson and colleagues from England determined the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhea associated with antibiotic use that was caused by Clostridium difficile.
The team assessed 135 hospital patients, with a mean age of 74, taking antibiotics.
Exclusions included diarrhea on admission, and bowel pathology that could result in diarrhea.
|12% of the probiotic group had diarrhea vs 34% in the placebo group |
|British Medical Journal|
The team excluded those with antibiotic use in the previous 4 weeks, severe illness, immunosuppression, and bowel surgery.
Patietns with artificial heart valves, and history of rheumatic heart disease or infective endocarditis were also excluded.
The team found that a consumption of a 100 g drink containing Lactobacillus casei, L bulgaricus, and Streptococcus thermophilus twice a day during a course of antibiotics.
This regimen was also taken for 1 week after the course finished.
The placebo group received a longlife sterile milkshake.
The research team found that the occurrence of antibiotic associated diarrhea, presence of C difficile toxin and diarrhea.
The researchers found that 12% of the probiotic group developed diarrhea associated with antibiotic use compared with 34% in the placebo group.
Logistic regression to control for other factors gave an odds ratio of 0.25 for use of the probiotic, with low albumin and sodium also increasing the risk of diarrhea.
The absolute risk reduction was 22%, and the number needed to treat was 5.
The research team observed that no one in the probiotic group and 17% in the placebo group had diarrhea caused by C difficile.
The team noted that the absolute risk reduction was 17%, and the number needed to treat was 6.
Ms Hickson's team concluded, "Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhea and C difficile associated diarrhea."
"This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50."