Antibiotic-associated diarrhea is a common complication of most antibiotics and Clostridium difficile.
C difficile is also a leading cause of nosocomial outbreaks of diarrhea and colitis.
The use of probiotics for these 2 related diseases remains controversial.
Dr Lynne McFarland compared the efficacy of probiotics for the prevention of antibiotic-associated diarrhea, and the treatment of C difficile.
The investigator assessed published randomized, controlled clinical trials.
PubMed, Medline, Google Scholar, and the National Institutes of Health registry of clinical trials was searched.
|S boulardii, L rhamnosus GG, and probiotic mixtures reduced antibiotic-associated diarrhea|
|American Journal of Gastroenterology|
The investigator also searched the MetaRegister, and Cochrane Central Register of Controlled Trials from 1977 to 2005, unrestricted by language.
Secondary searches of reference lists, authors, reviews, commentaries, associated diseases, books, and meeting abstracts were assessed.
The investigator included trials in which specific probiotics were given to either prevent or treat the diseases of interest.
Trials were required to be randomized, controlled, blinded efficacy trials in humans published in peer-reviewed journals.
Trials that were excluded were pre-clinical, safety, Phase 1 studies in volunteers, reviews, duplicate reports, and trials of unspecified probiotics.
The investigator also excluded trials of prebiotics, where trials did not assess the disease being studied, or trials with inconsistent outcome measures.
Of the 180 screened studies, 30 including 3164 subjects met the inclusion criteria.
From 25 randomized controlled trials, the investigator found that probiotics significantly reduced the relative risk of antibiotic-associated diarrhea.
There 3 types of probiotics included Saccharomyces boulardii, Lactobacillus rhamnosus GG, and probiotic mixtures.
The pooled result from 6 randomized trials showed that probiotics had significant efficacy for C difficile disease.
Dr McFarland commented, “A variety of different types of probiotics show promise as effective therapies for these 2 diseases.”
“Using meta-analyses, 3 types of probiotics significantly reduced the development of antibiotic-associated diarrhea.”
“Only S boulardii was effective for C difficile disease.