Feasibility and tolerability of probiotics for prevention of antibiotic-associated diarrhoea in hospitalized US military veterans

Probiotics may be efficacious for the prevention of antibiotic-associated diarrhoea. The tolerability and acceptability of probiotics in an elderly US veteran population has not been assessed. To undertake a randomized trial to determine the tolerability and acceptability of a probiotic, Florajen((R)) in an elderly population with multiple comorbidities. Pilot randomized double-blind trial comparing a probiotic, Florajen((R)) to placebo for the prevention of antibiotic-associated diarrhoea in elderly hospitalized patients receiving antibiotics. Forty patients were enrolled and randomized. Antibiotic-associated diarrhoea occurred in 6/16 (37%) in the placebo group and 4/23 (17%) patients in the Florajen((R)) group, (RR 1.63, 95% CI 0.73-3.65, P = 0.15). Florajen((R)) was well tolerated in the study population with no major side effects that necessitated discontinuation. In this pilot study, Florajen((R)) was well tolerated in an elderly population, all of whom were taking several other medications. A larger study is needed to determine the effect of Florajen((R)) on antibiotic-associated diarrhoea and Clostridium difficile infection.