Nutrition economic evaluation of a probiotic in the prevention of antibiotic-associated diarrhea

Abstract

Introduction: Antibiotic-associated diarrhea (AAD) is common and frequently more severe in hospitalized elderly adults. It can lead to increased use of healthcare resources. We estimated the cost-effectiveness of a fermented milk (FM) with probiotic in preventing AAD and in particular Clostridium difficile-associated diarrhea (CDAD).Methods: Clinical effectiveness data and cost information were incorporated in a model to estimate the cost impact of administering a FM containing the probiotic Lactobacillus paracasei ssp paracasei CNCM I-1518 in a hospital setting. Preventing AAD by the consumption of the probiotic was compared to no preventive strategy.Results: The probiotic intervention to prevent AAD generated estimated mean cost savings of £339 per hospitalized patient over the age of 65 years and treated with antibiotics, compared to no preventive probiotic. Estimated cost savings were sensitive to variation in the incidence of AAD, and to the proportion of patients who develop non-severe/severe AAD. However, probiotics remained cost saving in all sensitivity analyses.Conclusion: Use of the fermented dairy drink containing the probiotic L. paracasei CNCM I-1518 to prevent AAD in older hospitalized patients treated with antibiotics could lead to substantial cost savings.

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis

“…One costÀbenefit analysis conducted in the United Kingdom evaluated the use of Lactobacillus paracasei in hospitalized adults older than 65 years who were taking antibiotics and estimated a cost savings of >$500 per patient treated (£339). 52 Similarly, a recent study from Canada concluded that probiotic use would also be cost saving in the Canadian health system. 53 Uncertainties about the optimal probiotic formulation, dose, duration, and commercial source prevent specific clear practical recommendations.…”

Probiotics, D–Lactic acidosis, oxidative stress and strain specificity

“…33,36,40 Furthermore, numerous clinical studies have reported therapeutic efficacy with the use of D(¡), L(C) and DL-Lactic acid producing bacteria without producing D-Lactic acidosis ( Table 2). [41][42][43][44][45][46][47][48][49][50][51][52][53] The misinterpretation of D-Lactate producing bacteria has created an almost deliberate atmosphere of scientific nonsense regarding D(¡)-Lactate producing probiotics. The net result has some industry suppliers of probiotic formulations hastening to deliver D-Lactate free probiotic formulations together with a misinformed marketing hype that misleads and confuses healthcare practitioners and the public, for nothing more than monetary gain.…”

Antifungal defense of probiotic Lactobacillus rhamnosus GG is mediated by blocking adhesion and nutrient depletion

“…A number of trials show a positive effect of probiotics in the treatment of various diseases and disorders, e.g. atopic dermatitis [5], irritable bowel syndrome [6, 7], ulcerative colitis [8] and antibiotic-associated diarrhea[9]. Even preterm neonates are medicated with probiotics to prevent infections [10–12].…”