Probiotics for treatment of Clostridium difficile-associated colitis in adults

Abstract

There is insufficient evidence to recommend probiotic therapy as an adjunct to antibiotic therapy for C. difficile colitis. There is no evidence to support the use of probiotics alone in the treatment of C. difficile colitis.

Probiotics and Fecal Microbiota Transplant for Primary and Secondary Prevention of Clostridium difficile Infection

“…This meta‐analysis demonstrated significant reduction in the incidence of primary or recurrent CDI with probiotics (RR 0.59, 95% CI, 0.41–0.85, p=0.005). Subgroup analyses had similar findings as the Cochrane review, with only S. boulardii significantly reducing recurrences of CDI …”

Probiotics and Fecal Microbiota Transplant for Primary and Secondary Prevention of Clostridium difficile Infection

“…This meta‐analysis demonstrated significant reduction in the incidence of primary or recurrent CDI with probiotics (RR 0.59, 95% CI, 0.41–0.85, p=0.005). Subgroup analyses had similar findings as the Cochrane review, with only S. boulardii significantly reducing recurrences of CDI …”

Clostridioides (Clostridium) difficile infection: Review of literature

“…A retrospective study which included 18 patients with severe CDI who received IVIG in addition to IV metronidazole and/or oral/rectal vancomycin and 61 patients did not receive IVIG therapy. This study showed no significant difference in the study groups regarding mortality or length of stay in the hospital [44].…”

“…A pilot randomized controlled trial was done which included 33 participants from February 2013 to February 2015. This trial found that probiotic adjunctive therapy was associated with significant improvement in diarrhea outcomes; however, there was no significant difference in the rate of CDI or functional improvement over time between treatment groups [44].…”

Probiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration

“…We identified five Cochrane reviews focused on treatment or prevention of diarrhea-related conditions, including pediatric antibiotic associated diarrhea, acute infectious diarrhea, and Clostridium difficile-associated diarrhea [33–37]. Two of the Cochrane reviews focused on children, one focused on adults, and two studied both populations.…”

Probiotics and Fecal Microbiota Transplant for Primary and Secondary Prevention of Clostridium difficile Infection

“…This meta‐analysis demonstrated significant reduction in the incidence of primary or recurrent CDI with probiotics (RR 0.59, 95% CI, 0.41–0.85, p=0.005). Subgroup analyses had similar findings as the Cochrane review, with only S. boulardii significantly reducing recurrences of CDI …”

Clostridioides (Clostridium) difficile infection: Review of literature

“…A retrospective study which included 18 patients with severe CDI who received IVIG in addition to IV metronidazole and/or oral/rectal vancomycin and 61 patients did not receive IVIG therapy. This study showed no significant difference in the study groups regarding mortality or length of stay in the hospital [44].…”

“…A pilot randomized controlled trial was done which included 33 participants from February 2013 to February 2015. This trial found that probiotic adjunctive therapy was associated with significant improvement in diarrhea outcomes; however, there was no significant difference in the rate of CDI or functional improvement over time between treatment groups [44].…”

Probiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration

“…We identified five Cochrane reviews focused on treatment or prevention of diarrhea-related conditions, including pediatric antibiotic associated diarrhea, acute infectious diarrhea, and Clostridium difficile-associated diarrhea [33–37]. Two of the Cochrane reviews focused on children, one focused on adults, and two studied both populations.…”

Probiotics and Fecal Microbiota Transplant for Primary and Secondary Prevention of Clostridium difficile Infection

“…This meta‐analysis demonstrated significant reduction in the incidence of primary or recurrent CDI with probiotics (RR 0.59, 95% CI, 0.41–0.85, p=0.005). Subgroup analyses had similar findings as the Cochrane review, with only S. boulardii significantly reducing recurrences of CDI …”

Clostridioides (Clostridium) difficile infection: Review of literature

“…A retrospective study which included 18 patients with severe CDI who received IVIG in addition to IV metronidazole and/or oral/rectal vancomycin and 61 patients did not receive IVIG therapy. This study showed no significant difference in the study groups regarding mortality or length of stay in the hospital [44].…”

“…A pilot randomized controlled trial was done which included 33 participants from February 2013 to February 2015. This trial found that probiotic adjunctive therapy was associated with significant improvement in diarrhea outcomes; however, there was no significant difference in the rate of CDI or functional improvement over time between treatment groups [44].…”

Probiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration

“…We identified five Cochrane reviews focused on treatment or prevention of diarrhea-related conditions, including pediatric antibiotic associated diarrhea, acute infectious diarrhea, and Clostridium difficile-associated diarrhea [33–37]. Two of the Cochrane reviews focused on children, one focused on adults, and two studied both populations.…”