The Effect of Lactobacillus plantarum 299v on the Incidence of Clostridium difficile Infection in High Risk Patients Treated with Antibiotics

Abstract

Background: Lactobacillus plantarum 299v (LP299v) has been used in order to reduce gastrointestinal symptoms during antibiotic exposure. However, it remains controversial whether or not probiotics are effective in the prevention of Clostridium difficile infections (CDI) among patients receiving antibiotics. The aim of this study was to analyze the CDI among patients receiving antibiotics and hospitalized in the period before and after starting routine use of LP299v as a prevention of this infection. Methods: Among 3533 patients hospitalized in the nephrology and transplantation ward during a two-year period, 23 patients with CDI were diagnosed and enrolled in this retrospective study. Since November 2013, prevention of CDI with oral use of LP299v was performed in all patients treated with antibiotics and who were at a high risk of developing CDI. The observation period was divided into two twelve-month intervals before and after initiation of the use of LP299v as a prophylactic against CDI. Results: A significant (p = 0.0001) reduction of the number of cases of CDI was found after routinely using LP299v (n = 2; 0.11% of all hospitalized patients) compared with the previous twelve-month period of observation (n = 21; 1.21% of all hospitalized patients). Conclusions: Routine use of LP299v during treatment with antibiotics may prevent C. difficile infection in the nephrology and transplantation ward.

Clostridium Difficile Infection in the Nephrology Ward

“…Since December 2013, all patients with a high risk of CDI have been given LP299v (one capsule orally per day containing at least 10 x 10 9 colony forming units (CFU) of LP299v) as a preventative measure for CDI. A highly significant reduction of the incidence of CDI was observed after the introduction of LP299v as prophylaxis of CDI (1.21% vs 0.11%, P.0001) (Table 2) [43]. The results of this retrospective study suggest that routine administration of Lactobacillus plantarum 299v during treatment with antibiotics prevents CDI in patients at high risk of CDI.…”

The Role of the Microbiota in the Prevention of Hospital Infections

“…Genelde C. difficile infeksiyonunu (CDI) ve ishali önlemek ve genel insan sağlığını geliştirmek için probiyotik kullanımı üzerine her yıl artan bir ilgi vardır. Yapılan bir çalışmada, Lactobacillus plantarum 299v (günde 10 milyar CFU) ile profilaktik olarak antibiyotik alan yüksek riskli bir hasta popülasyonunda CDI insidansında belirgin bir düşüş olduğu gösterilmiştir [28] . Yine yapılan bir çalışmada, Bacteroides, Lachnospiraceae ve Ruminococcaceae türlerinin CDI insidansını azalttığı gösterilmiştir [29] .…”

Probiotics as adjunctive therapy for preventing Clostridium difficile infection – What are we waiting for?

“…A recent clinical trial using the single organism, L. plantarum 299v (10 billion CFU daily), prophylactically in a high-risk patient population taking antibiotics showed a significant decrease in CDI incidence (0.11% vs 1.21%; p = 0.0001). 82 Studies indicating the importance of bile acid metabolism by GI microbiota in providing moderate C. difficile colonization resistance in a mouse model 81,83 suggest that single organisms with specific functions may be sufficient. However, multi-strain bacteriotherapies may be more akin to FMT at modulating microbial communities and providing increased diversity after sequential antibiotic treatments.…”