__smbhome.uscs.susx.ac.uk_tjk30_Documents_FINAL Probiotics paper SUBMISSION MANUSCRIPT TO JHI v7 01.11.19.pdf (430.87 kB)
Do probiotics prevent antibiotic associated diarrhoea? Results of a multicentre randomised placebo controlled trial
Version 2 2023-06-12, 09:22
Version 1 2023-06-09, 20:36
journal contribution
posted on 2023-06-12, 09:22 authored by Chakravarthi RajkumarChakravarthi Rajkumar, M Wilks, Jasmin Islam, Khalid Mustafa AliKhalid Mustafa Ali, J Raftery, Kevin DaviesKevin Davies, J Timeyin, E Cheek, J CohenBackground: Antibiotic-associated diarrhoea (AAD) is a side-effect of antibiotic consumption and probiotics have been shown to reduce AAD. Methods: We conducted a multicentre, double-blind, placebo-controlled, randomised trial to evaluate the role of L. casei DN114001 (combined as a drink with two regular yoghurt bacterial strains) in reducing AAD and C. difficile infection in patients aged over 55 years. The primary outcome was the incidence of AAD during 2 weeks follow up. Results: 1127 patients, (mean age + SD 73.6 + 10.5), were randomised to the active group (n=549) or placebo group (n=577). Both groups were followed up as per protocol. Patients experiencing AAD during follow-up was 19.3% (106/549) in probiotic group vs 17.9% (103/577) in placebo group (unadjusted OR 1.10, 95% CI 0.82 - 1.49, p = 0.53). Conclusions: We did not find any significant evidence 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 the 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.
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Publication status
- Published
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- Accepted version
Journal
Journal of Hospital InfectionISSN
0195-6701Publisher
ElsevierExternal DOI
Department affiliated with
- BSMS Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2020-02-13First Open Access (FOA) Date
2021-02-07First Compliant Deposit (FCD) Date
2020-05-19Usage metrics
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