Probiotics for the prevention of antibiotics associated diarrhea: a systematic review

Scheike I, Connock M, Taylor R, Fry-Smith A, Ward D
Record ID 32006000676
English
Authors' objectives:

The aim of this report is to assess the clinical effectiveness and cost effectiveness of probiotics for the prevention of antibiotic associated diarrhoea (AAD).

Authors' results and conclusions: The results of this review suggest that probiotics can significantly decrease the incidence and duration of AAD by 52% (95% CI: 37% to 63%) and by 0.6 days (95% CI: 0.04 to 1.11) respectively. The benefit of probiotics is found in the comparison with placebo or no treatment (RR=0.48, 95% CI 0.37 ; 0.63, NNT=8) However, the incidence of AAD did not differ between probiotic and active comparator groups (RR: 1.45, 95% CI: 0.91 to 2.30). Furthermore, the incidence of C. difficile associated diarrhoea was reduced by 46% (95% CI: 14%-76%, NNT= 36). However, colonisation by C. difficile did not differ between the probiotic and placebo groups (RR: 0.95; 95% CI: 0.66-1.36). Probiotics have no effect on the severity and time to developing symptoms of diarrhoea. There were no reports with adverse events with probiotics.
Authors' recommendations: Probiotics appear to be effective in the prevention of AAD including C. difficile and have little or no harmful effects. Given the low cost of a course of treatment and their potential to reduce downstream healthcare resource utilisation, probiotics may well be cost saving.
Authors' methods: Systematic review
Details
Project Status: Completed
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Costs and Cost Analysis
  • Probiotics
  • Diarrhea
Contact
Organisation Name: West Midlands Health Technology Assessment Collaboration
Contact Address: Elaena Donald-Lopez, West Midlands Health Technology Assessment Collaboration, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT Tel: +44 121 414 7450; Fax: +44 121 414 7878
Contact Name: louise.a.taylor@bham.ac.uk
Contact Email: louise.a.taylor@bham.ac.uk
Copyright: University of Birmingham
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