Probiotics May Reduce the Incidence of Antibiotic and Clostridium Difficile-associated Diarrhea
A study involving 135 hospital patients with a mean age of 74 years receiving antibiotic treatment were randomized into a double-blind, placebo controlled study. Subjects in the study group received 100 g (97 ml) of the probiotic drink twice a day. The drink contained Lactobacillus casei, Lactobacillus bulgaricus and Streptococcus thermophilus.
Results found that only 12% of the subjects in the probiotics group developed antibiotic-associated diarrhea compared to 34% in the placebo group. Furthermore, while 17% of subjects in the placebo group developed diarrhea due to C difficile, not a single subject in the probiotics group developed C difficile-associated diarrhea. The absolute risk reduction of antibiotic-associated diarrhea as 21.6% (number to treat:5) and the absolute risk reduction of C difficile associated diarrhea was 17% (number to treat: 6).
These results suggest that consumption of a yogurt drink supplemented with the above named probiotics may reduce the incidence of antibiotic-associated and C-difficile -associated diarrhea. The authors concluded “This has the potential to decrease morbidity, healthcare costs and mortality if used routinely in patients aged over 50.”
It might be noted that I previously published a story on deaths associated with probiotic use in pancreatic patients. We must be careful in extrapolating results. The study where the deaths occurred had multiple variables that this study did not mention. First of all, the study recipients mentioned here were drinking a probiotic drink as opposed to having a capsule flushed down a tube as a medication would be delivered via a tube feeding. Secondly, the medical diagnoses were not standardized in this study whereas in the previous study I wrote about all the patients had pancreatitis.
I think that method of delivery and the type of patients we are dealing with (i.e medical diagnosis) might interplay to make a vast difference in the results obtained from probiotic studies. I personally feel that while we may be having positive results with orally administered yogurt based probiotic drinks, the utmost caution should be upheld when we go from drinks to administering a probiotic pill down a tube feed. I believe that further studies are needed particularly in anyone with pancreatitis. Also, probiotics delivered down a tube feed via a capsule should be brought before the proper committees before this is attempted and it should be treated as a drug, not a nutritional supplement at this point.
Because of the controversial results of studies, I also recommend that probiotics delivered down a tube feed be treated as if it were a study based approach as there is no evidence to support efficacy. There is, on the other hand, evidence to support that we may be doing more harm than good by administering probiotics in the form of a medication delivered down a tube feeding port. In conclusion, many more studies are needed on the differing uses of probiotics in various disease states and via different delivery methods.
Source: Vitasearch, Summary # 46226
About the Author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
