#DoesItWorkSummary: Probiotics against Clostridium difficile Infections

By Atanas G. Atanasov

Background: This #DoesItWorkSummary is based on the findings of a systematic review and meta‐analysis of clinical trials study published in the journal Gastroenterology in June 2017 [1]. Clostridium difficile infections often cause diarrhea, but sometimes also life-threatening inflammation of the colon [2]. Alone in 2011, 29,000 deaths due Clostridium difficile infections were reported in the United States [3]. Clostridium difficile infections most commonly occur in hospitalized older adults, often after antibiotic treatment causing dysbiosis (disturbed balance between beneficial and harmful gut microbes). Probiotics are beneficial microbes that can be taken orally and promote the maintenance of a healthy microbial composition of the gut. A systematic evaluation of the available human trial data was done to get overview if probiotics administration together with antibiotics can prevent Clostridium difficile infections among hospitalized adults.

#DoesItWorkSummary: Probiotics against Clostridium difficile Infections

Findings: Analyzed were 19 trials involving 6261 people [1]. Probiotics significantly decreased the rate Clostridium difficile infections, with stronger effect when they were first taken in a closer time to the administration of the first antibiotic dose. If taken within 2 days after the initiation of the antibiotic treatment, probiotics reduced around twice the incidence of Clostridium difficile infections. Moreover, there were no significant side effects linked to the probiotics intake.


1          Shen, N.T., Maw, A., Tmanova, L.L., Pino, A., Ancy, K., Crawford, C. V., Simon, M.S. and Evans, A.T. (2017) Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium Difficile Infection: A Systematic Review With Meta-Regression Analysis. Gastroenterology, 152, 1889–1900.e9. https://doi.org/10.1053/j.gastro.2017.02.003.

2           C. Difficile Infection – Symptoms and Causes – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691.

3          Lessa, F.C., Mu, Y., Bamberg, W.M., Beldavs, Z.G., Dumyati, G.K., Dunn, J.R., Farley, M.M., Holzbauer, S.M., Meek, J.I., Phipps, E.C., Wilson, L.E., Winston, L.G., Cohen, J.A., Limbago, B.M., Fridkin, S.K., Gerding, D.N. and McDonald, L.C. (2015) Burden of Clostridium Difficile Infection in the United States. New England Journal of Medicine, 372, 825–834. https://doi.org/10.1056/NEJMoa1408913.

Keywords: #DoesItWorkSummary, probiotics, Clostridium difficile infections, diarrhea, inflammation of the colon, dysbiosis.

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