Probiotics to prevent <I>C. difficile</I> infection in patients receiving antibiotics

U.S. and European medical societies do not explicitly recommend probiotic prophylaxis for patients taking antibiotics, but one group of researchers suggests the intervention may deserve more attention.

U.S. and European medical societies do not explicitly recommend probiotic prophylaxis for patients taking antibiotics, but one group of researchers suggests the intervention may deserve more attention. The team conducted a Cochrane review of 31 published studies that investigated the effect of probiotics in cases of Clostridium difficile infection (CDI), which is commonly treated with antibiotic agents. Based on moderate-quality evidence, co-administration of antibiotics and probiotics appeared to reduce the risk of CDI vs. placebo or no treatment. The finding held true even in predefined subsets, including inpatients, outpatients, probiotic doses, age groups, and probiotic species or strains. The data also pointed to fewer adverse events—such as abdominal cramping and nausea—as well as lower risk of antibiotic-associated diarrhea with probiotics, although the quality of evidence supporting these conclusions was categorized as very low. More research is warranted, according to the review authors, to flag high-risk populations who may benefit most from dual treatment with probiotics and antibiotics—for example, patients with a history of CDI or those known to be colonized with C difficile.