Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial

Objective To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. Design Randomised double blind placebo controlled study. Participants 135 hospital patients (mean age 74) tak...

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Main Authors: Hickson, Mary, D'Souza, Aloysius L, Muthu, Nirmala, Rogers, Thomas R, Want, Susan, Rajkumar, Chakravarthi, Bulpitt, Christopher J
Formato: Artigo
Idioma:English
Publicado em: BMJ Publishing Group Ltd. 2007
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Research
Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC1914504/
https://ncbi.nlm.nih.gov/pubmed/17604300
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1136/bmj.39231.599815.55
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spelling pubmed-19145042007-07-15 Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial Hickson, Mary D'Souza, Aloysius L Muthu, Nirmala Rogers, Thomas R Want, Susan Rajkumar, Chakravarthi Bulpitt, Christopher J BMJ Research Objective To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. Design Randomised double blind placebo controlled study. Participants 135 hospital patients (mean age 74) taking antibiotics. Exclusions included diarrhoea on admission, bowel pathology that could result in diarrhoea, antibiotic use in the previous four weeks, severe illness, immunosuppression, bowel surgery, artificial heart valves, and history of rheumatic heart disease or infective endocarditis. Intervention Consumption of a 100 g (97 ml) drink containing Lactobacillus casei, L bulgaricus, and Streptococcus thermophilus twice a day during a course of antibiotics and for one week after the course finished. The placebo group received a longlife sterile milkshake. Main outcome measures Primary outcome: occurrence of antibiotic associated diarrhoea. Secondary outcome: presence of C difficile toxin and diarrhoea. Results 7/57 (12%) of the probiotic group developed diarrhoea associated with antibiotic use compared with 19/56 (34%) in the placebo group (P=0.007). Logistic regression to control for other factors gave an odds ratio 0.25 (95% confidence interval 0.07 to 0.85) for use of the probiotic, with low albumin and sodium also increasing the risk of diarrhoea. The absolute risk reduction was 21.6% (6.6% to 36.6%), and the number needed to treat was 5 (3 to 15). No one in the probiotic group and 9/53 (17%) in the placebo group had diarrhoea caused by C difficile (P=0.001). The absolute risk reduction was 17% (7% to 27%), and the number needed to treat was 6 (4 to 14). Conclusion Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhoea and C difficile associated diarrhoea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50. Trial registration National Research Register N0016106821. BMJ Publishing Group Ltd. 2007-07-14 /pmc/articles/PMC1914504/ /pubmed/17604300 http://dx.doi.org/10.1136/bmj.39231.599815.55 Text en © BMJ Publishing Group Ltd 2007
institution US National Library of Medicine
collection PubMed Central
language English
format Article
topic Research
spellingShingle Research
Hickson, Mary
D'Souza, Aloysius L
Muthu, Nirmala
Rogers, Thomas R
Want, Susan
Rajkumar, Chakravarthi
Bulpitt, Christopher J
Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
description Objective To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. Design Randomised double blind placebo controlled study. Participants 135 hospital patients (mean age 74) taking antibiotics. Exclusions included diarrhoea on admission, bowel pathology that could result in diarrhoea, antibiotic use in the previous four weeks, severe illness, immunosuppression, bowel surgery, artificial heart valves, and history of rheumatic heart disease or infective endocarditis. Intervention Consumption of a 100 g (97 ml) drink containing Lactobacillus casei, L bulgaricus, and Streptococcus thermophilus twice a day during a course of antibiotics and for one week after the course finished. The placebo group received a longlife sterile milkshake. Main outcome measures Primary outcome: occurrence of antibiotic associated diarrhoea. Secondary outcome: presence of C difficile toxin and diarrhoea. Results 7/57 (12%) of the probiotic group developed diarrhoea associated with antibiotic use compared with 19/56 (34%) in the placebo group (P=0.007). Logistic regression to control for other factors gave an odds ratio 0.25 (95% confidence interval 0.07 to 0.85) for use of the probiotic, with low albumin and sodium also increasing the risk of diarrhoea. The absolute risk reduction was 21.6% (6.6% to 36.6%), and the number needed to treat was 5 (3 to 15). No one in the probiotic group and 9/53 (17%) in the placebo group had diarrhoea caused by C difficile (P=0.001). The absolute risk reduction was 17% (7% to 27%), and the number needed to treat was 6 (4 to 14). Conclusion Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhoea and C difficile associated diarrhoea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50. Trial registration National Research Register N0016106821.
author Hickson, Mary
D'Souza, Aloysius L
Muthu, Nirmala
Rogers, Thomas R
Want, Susan
Rajkumar, Chakravarthi
Bulpitt, Christopher J
author_facet Hickson, Mary
D'Souza, Aloysius L
Muthu, Nirmala
Rogers, Thomas R
Want, Susan
Rajkumar, Chakravarthi
Bulpitt, Christopher J
author_sort Hickson, Mary
title Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
title_short Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
title_full Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
title_fullStr Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
title_full_unstemmed Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
title_sort use of probiotic lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial
publisher BMJ Publishing Group Ltd.
publisher_facet BMJ Publishing Group Ltd.
publishDate 2007
url https://ncbi.nlm.nih.gov/pmc/articles/PMC1914504/
https://ncbi.nlm.nih.gov/pubmed/17604300
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1136/bmj.39231.599815.55
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