Probiotics May Mitigate C diff Risk

Probiotic use may aid in the prevention of Clostridium difficile infection (CDI) in adults and children, especially among those taking at least 2 antibiotics and those in hospital settings with a CDI risk of at least 5%, according to a recent meta-analysis.

In their analysis, researchers evaluated data from 32 randomized controlled trials (N = 8713), of which 18 trials (n =  6851) provided individual participant data for probiotic prophylaxis vs placebo or no treatment (standard of care).
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Data were obtained from 6 databases and 11 grey literature sources from inception until April 2016.

Findings from the analysis indicated that probiotic use was associated with a reduced risk of CDI in both the unadjusted model (n = 6645; odds ratio [OR] 0.37) and the adjusted model (n = 5074; OR 0.35). The use of 2 or more antibiotics was found to increase the risk of CDI (OR 2.20). However, age, sex, hospitalization status, and high-risk antibiotic exposure did not raise this risk.

In particular, the researchers found that multispecies probiotics provided more benefit than single-species probiotics compared with no probiotics. Probiotic use in clinical settings where the risk for CDI is at least 5% was also found to be beneficial compared with no probiotics.

The researchers noted that the risk for serious adverse events were similar for both groups in both adjusted (n = 4718; OR 1.06) and unadjusted analyses (n = 4990; OR 1.06).

“Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is [at least 5%],” the researchers concluded.

—Christina Vogt

Reference:

Johnston BC, Lytvyn L, Ka-Fung Lo C, et al. Microbial preparations (probiotics) for the prevention of Clostridium difficile infection in adults and children: an individual patient data meta-analysis of 6851 participants [Published online April 26, 2018]. Infect Control Hosp Epidemiol. https://doi.org/10.1017/ice.2018.84

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