Do probiotics prevent antibiotic associated diarrhoea? Results of a multicentre randomised placebo controlled trial
Autor: | C. Rajkumar, M. Wilks, J. Islam, K. Ali, J. Raftery, K.A. Davies, J. Timeyin, E. Cheek, J. Cohen, J. Wright, U. Natarajan, C. Nicholl, G. Dewhurst, M. Fonseka, D. Slovick, P. Maskell, S. Mukherjee, R. Nari, A. Qureshi, D. Gertner, Z. Khan, N. Shinh, C. Bodmer, C. Martin-Marero, A. Poullis, R. Pollok, A. Ala, A. Chauhan, M. Patel, H. Roberts, S. Conroy, D. McGowan, R. Pathansali, C.Y. Yau, E. Vasileiadis, A. Guleri, David Orr, David Aldulami |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Diarrhea
Male Microbiology (medical) medicine.medical_specialty medicine.drug_class Antibiotics Placebo-controlled study 030501 epidemiology law.invention 03 medical and health sciences Probiotic Double-Blind Method Randomized controlled trial law Internal medicine medicine Humans Infection control Aged Aged 80 and over 0303 health sciences 030306 microbiology business.industry Incidence Probiotics Incidence (epidemiology) General Medicine Odds ratio Middle Aged Yogurt Hospitals United Kingdom Confidence interval Anti-Bacterial Agents Lacticaseibacillus casei Infectious Diseases Clostridium Infections Female 0305 other medical science business |
ISSN: | 0195-6701 |
Popis: | Summary Background Antibiotic-associated diarrhoea (AAD) is a side-effect of antibiotic consumption and probiotics have been shown to reduce AAD. Methods A multicentre, double-blind, placebo-controlled, randomized trial was conducted to evaluate the role of Lactobacillus casei DN114001 (combined as a drink with two regular yoghurt bacterial strains) in reducing AAD and Clostridioides difficile infection in patients aged over 55 years. The primary outcome was the incidence of AAD during 2 weeks of follow-up. Results A total of 1127 patients (mean age ± standard deviation: 73.6 ± 10.5) were randomized to the active group (N = 549) or placebo group (N = 577). Both groups were followed up as per protocol. The proportion of patients experiencing AAD during follow-up was 19.3% (106/549) in the probiotic group vs 17.9% (103/577) in the placebo group (unadjusted odds ratio 1.10, 95% confidence interval 0.82–1.49, P = 0.53). Conclusions No significant evidence was found of a beneficial effect of the specific probiotic formulation in preventing AAD in this elderly population drawn from a number of different UK hospitals. However, in the UK and in many other healthcare systems there have, in recent years, been many changes in antibiotic stewardship policies, an overall decrease in incidence in C. difficile infection, as well as an increased awareness of infection prevention, and modifications in nursing practice. In light of these factors, it is impossible to conclude definitively from the current trial that the study-specific probiotic formulation has no role in preventing AAD, and it is our view that further trials may be indicated, controlling for these variables. |
Databáze: | OpenAIRE |
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