Probiotics for the prevention of anti biotic-associated diarrhea and Clostridium difficile diarrhea

Antibiotic-associated diarrhea is a common clinical problem Occurring in tip to 25% of patients, with diarrhea owing to Clostridium difficile accounting for tip to a quarter of cases. The clinical and economic costs of antibiotic-associated diarrhea are significant and better treatments are needed. Probiotics may offer potential effective therapy for antibiotic-associated diarrhea by restoring intestinal microbial balance. A number of different probiotics have been evaluated in the prevention and treatment of antibiotic-associated diarrhea in adults and children, including the nonpathogenic yeast Saccharomyces boulardii and multiple lactic-acid fermenting bacteria Such Lis Lactobacillus rhamnosus GG (LGG) A careful review of the literature supports the efficacy of S. boulardii in the prevention of antibiotic-associated diarrhea recurrent C. difficile infection in adults, whereas LGG is useful in the treatment of antibiotic-associated diarrhea in children. Not enough data exist to currently support the use of other probiotic preparations ill these conditions. Although generally safe and well tolerated. both S. boulardu and LGG should be used cautiously in immunocompromised patients. Further study of probiotics, including large, well-designed, randomized controlled dose-ranging trials, comparative trials, and cost-benefit analyses are necessary.