Do Probiotics Prevent C. difficile-Associated Diarrhea in Patients Receiving Antibiotics?

A meta-analysis suggests that most inpatients — with specific exclusions — benefit from probiotic prophylaxis.

Hospitalization and antibiotic use are major independent risk factors for Clostridium difficile-associated diarrhea (CDAD), and probiotic prophylaxis can lessen CDAD's occurrence (NEJM JW Gastroenterol May 2017 and Gastroenterology 2017; 152:1889), but guidelines have not yet endorsed broad use of this preventive intervention.

In this meta-analysis of 31 randomized trials that involved >8500 patients (7000 were inpatients, 7800 were adults, 1100 were children, and 2500 had baseline CDAD risk >5%), significant effects on CDAD incidence for probiotics compared with control (placebo or no probiotic) were:

All patients: probiotics 1.5%, control 3.9%; number needed to treat (NNT), 42
Inpatients: probiotics 1.7%, control 4.2%; NNT, 40
Adults: probiot…

Reviewing Author

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Do Probiotics Prevent C. difficile-Associated Diarrhea in Patients Receiving Antibiotics?

Topics

Reviewing Author