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Antibiotic-associated Diarrhoea (antibiotic-associated + diarrhoea)
Selected AbstractsFeasibility and tolerability of probiotics for prevention of antibiotic-associated diarrhoea in hospitalized US military veteransJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 6 2008N. Safdar MD MS Summary Background:, Probiotics may be efficacious for the prevention of antibiotic-associated diarrhoea. The tolerability and acceptability of probiotics in an elderly US veteran population has not been assessed. Purpose:, To undertake a randomized trial to determine the tolerability and acceptability of a probiotic, Florajen® in an elderly population with multiple comorbidities. Methods:, Pilot randomized double-blind trial comparing a probiotic, Florajen® to placebo for the prevention of antibiotic-associated diarrhoea in elderly hospitalized patients receiving antibiotics. Results:, Forty patients were enrolled and randomized. Antibiotic-associated diarrhoea occurred in 6/16 (37%) in the placebo group and 4/23 (17%) patients in the Florajen® group, (RR 1·63, 95% CI 0·73,3·65, P = 0·15). Florajen® was well tolerated in the study population with no major side effects that necessitated discontinuation. Conclusions:, In this pilot study, Florajen® was well tolerated in an elderly population, all of whom were taking several other medications. A larger study is needed to determine the effect of Florajen® on antibiotic-associated diarrhoea and Clostridium difficile infection. [source] Probiotics and gastrointestinal diseasesJOURNAL OF INTERNAL MEDICINE, Issue 1 2005Å. SULLIVAN Abstract. There is increasing evidence indicating health benefits by consumption of foods containing microorganisms, i.e. probiotics. A number of clinical trials have been performed to evaluate the effects in the prevention and treatment of gastrointestinal diseases caused by pathogenic microorganisms or by disturbances in the normal microflora. Gastrointestinal infections caused by Helicobacter pylori, traveller's diarrhoea, rotavirus diarrhoea, antibiotic-associated diarrhoea (AAD) and Clostridium difficile -induced diarrhoea are conditions that have been studied. There are also studies performed on the preventive effect of probiotics on radiation-induced diarrhoea and diarrhoea in tube-fed patients. Inflammatory bowel disease and irritable bowel syndrome, two idiopathic conditions where alterations in the normal microflora have been implicated as responsible for initiation, are two further areas where the use of probiotics has been regarded as promising. The results from clinical studies have not been conclusive in that the effects of probiotics have been strain-dependent and different study designs have been used. Treatment of acute diarrhoea in children and prevention of AAD are the two most justified areas for the application of probiotics. [source] Clinical trial: effectiveness of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) in the prevention of antibiotic-associated diarrhoea in childrenALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2008M. RUSZCZY Summary Background, Convincing evidence that probiotic administration can lower the risk of antibiotic-associated diarrhoea is limited to certain micro-organisms. Aim, To determine the efficacy of administration of Lactobacillus rhamnosus (strains E/N, Oxy and Pen) for the prevention of antibiotic-associated diarrhoea in children. Methods, Children (aged 3 months to 14 years) with common infections were enrolled in a double-blind, randomized, placebo-controlled trial in which they received standard antibiotic treatment plus 2 × 1010 colony forming units of a probiotic (n = 120) or a placebo (n = 120), administered orally twice daily throughout antibiotic treatment. Analyses were by intention to treat. Results, Any diarrhoea (,3 loose or watery stools/day for ,48 h occurring during or up to 2 weeks after the antibiotic therapy) occurred in nine (7.5%) patients in the probiotic group and in 20 (17%) patients in the placebo group (relative risk, RR 0.45, 95% confidence interval, CI 0.2,0.9). Three (2.5%) children in the probiotic group developed AAD (diarrhoea caused by Clostridium difficile or otherwise unexplained diarrhoea) compared to nine (7.5%) in the placebo group (RR 0.33, 95% CI 0.1,1.06). No adverse events were observed. Conclusion, Administration of L. rhamnosus (strains E/N, Oxy and Pen) to children receiving antibiotics reduced the risk of any diarrhoea, as defined in this study. [source] Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2005H. SZAJEWSKA Summary Background :,Antibiotic-associated diarrhoea occurs in up to 30% of patients who receive antibiotics but can be prevented with probiotics. Aim :,To systematically evaluate the effectiveness of Saccharomyces boulardii in preventing antibiotic-associated diarrhoea in children and adults. Methods :,Using medical subject headings and free-language terms, the following electronic databases were searched for studies relevant to antibiotic-associated diarrhoea and S. boulardii: MEDLINE, EMBASE, CINAHL and The Cochrane Library. Additional sources were obtained from references in reviewed articles. Only randomized-controlled trials were considered for study inclusion. Results :,Of 16 potentially relevant clinical trials identified, five randomized-controlled trials (1076 participants) met the inclusion criteria for this systematic review. Treatment with S. boulardii compared with placebo reduced the risk of antibiotic-associated diarrhoea from 17.2% to 6.7% (RR: 0.43; 95% CI: 0.23,0.78; random effect model). The number needed to treat to prevent one case of antibiotic-associated diarrhoea was 10 (95% CI: 7,16). No side-effects were reported. Conclusions :,A meta-analysis of data from five randomized-controlled trials showed that S. boulardii is moderately effective in preventing antibiotic-associated diarrhoea in children and adults treated with antibiotics for any reason (mainly respiratory tract infections). For every 10 patients receiving daily S. boulardii with antibiotics, one fewer will develop antibiotic-associated diarrhoea. [source] Failure of dietary oligofructose to prevent antibiotic-associated diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005S. Lewis Summary Background :,Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ,colonization resistance' against pathogenic bacteria. Aim :,To reduce the incidence of antibiotic-associated diarrhoea in elderly patients. Methods :,Patients over the age of 65 taking broad-spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results :,No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups (n = 435). Oligofructose increased bifidobacterial concentrations (P < 0.001, 95% CI: 0.69,1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile -positive and were more likely to be taking a cephalosporin (P = 0.006), be female (P < 0.001), to have lost more weight (P < 0.001, 95% CI: 0.99,2.00) and stayed longer in hospital (P < 0.001, 95% CI: 0.10,1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile (P = 0.006). Conclusion :,Oligofructose does not protect elderly patients receiving broad-spectrum antibiotics from antibiotic-associated diarrhoea whether caused by C. difficile or not. Oligofructose was well-tolerated and increased faecal bifidobacterial concentrations. [source] Candida and antibiotic-associated diarrhoeaCLINICAL MICROBIOLOGY AND INFECTION, Issue 1 2005R. Krause Abstract The role of Candida in antibiotic-associated diarrhoea (AAD) has been controversial for many years. Since Candida exists physiologically in the gastrointestinal tract, the presence of small numbers of Candida organisms in stool has therefore been considered normal, and thus non-pathogenic. Increased Candida counts have been linked to the development of diarrhoea in antibiotic-treated patients. However, recent findings have not confirmed this. To date, there is no convincing evidence that Candida may cause AAD in adults. [source] | ||||||||||