Title Concurrent probiotics reduce the risk of antibiotic induced diarrhea and clostridium difficile
Clinical Question In adult patients taking antibiotics post-treatment, does taking probiotics as opposed to not taking probiotics help to prevent secondary infection?
Clinical Bottom Line In adult patients taking post-op antibiotics, the concurrent use of probiotics reduced the incidence of both antibiotic-associated diarrhea and Clostridium difficile infection. This is supported by a systematic review of several randomized controlled trials in which the concurrent use of probiotics prevented antibiotic-associated diarrhea and Clostridium difficile infection. This treatment can be used by general dentists, and patients are likely to accept the treatment.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
24348885Pattani/201316 trials with 2,296 adult patients prescribed to antibioticsSystematic review of randomized trials
Key resultsPrimary comparison was the presence of antibiotics-associated diarrhea (AAD) and/or Clostridium difficile infection (CDI) in patients. There is a reduced risk of acquiring both when taking probiotics concurrently with antibiotics. Analyses revealed a significant decrease in the risks of AAD (RR 0.61, 95% CI 0.47 to 0.79) and CDI (RR 0.37, 95% CI o.22 to 0.61).
Evidence Search Probiotics AND antibiotics AND clostridium difficile
Comments on
The Evidence
Validity: This article covered a systematic review and meta-analysis of randomized controlled trials. Relevant trials were found using a comprehensive, detailed search, and the individual studies were assessed for validity. The study included 16 trials, with a total of 2,296 patients. Perspective: I believe the conclusion is valid, but that this topic should be further investigated to discover which probiotics are associated with the best results, which patients should be taking the probiotics, and which types of antibiotic prescriptions should be paired with probiotic intake.
Applicability Subjects were representative of patients, and the treatment is feasible in a general practice setting. With this treatment, patients could avoid both antibiotic-associated diarrhea and infection with Clostridium difficile when prescribed post-op antibiotics. Probiotics are not approved by the FDA, and could have potential side effects, but this has not been proven. It is likely that the benefits outweigh the risks associated with taking probiotics in conjunction with post-op antibiotics.
Specialty (General Dentistry)
Keywords Probiotics, Antibiotics, Clostridium difficile, secondary infection
ID# 3058
Date of submission 05/03/2016
E-mail ferrantek@livemail.uthscsa.edu
Author Kristen Ferrante
Co-author(s) e-mail
Faculty mentor Cara Gonzales, DDS, PhD
Faculty mentor e-mail gonzalesc5@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available