Research shows probiotics can minimize C. difficile in some hospital settings
TORONTO – Medical use of probiotics can significantly minimize C. difficile (Clostridium difficile) infection among hospitalized patients taking antibiotics, according to a research team that included University of Toronto scientists. The study was recently published in Annals of Internal Medicine.
Professor Bradley Johnston (Institute of Health Policy, Management and Evaluation) and researchers from The Hospital for Sick Children (SickKids) and McMaster University compiled findings from 20 randomized controlled trials including a total of 3818 patients. The trials tracked rates of probiotic use in inpatients and outpatients who were receiving antibiotics, and analyzed rates of diarrheal illness associated with C. difficile among the groups.
Overall, use of probiotics reduced the new cases of C. difficile-associated diarrhea by two thirds (66 per cent), with no serious adverse events attributable to probiotics.
“Probiotics are not a magic bullet, but these results suggest that therapeutic probiotic agents, as well as some yogurts and probiotic dairy products, may be vastly under-used in some nursing homes and hospitals,” says Johnston, who is a Scientist and Clinical Epidemiologist at SickKids.
The risk of serious C. difficile infection appears primarily among older hospitalized adults who are exposed to antibiotics.
Up to half of all diarrheal illness in hospital is associated with this infection, which is a significant cause of illness and death in hospitalized adults. From 2009-2011 the Ontario Ministry of Health and Long-Term Care tracked 75 outbreaks in 47 hospitals.
“Minimizing or even preventing C. difficile among vulnerable patients is a high priority for making every hospital as safe as possible. It’s an important public health issue,” adds Johnston.
Because immunocompromised and debilitated children are potentially at risk of systemic infection from probiotics, more research is needed regarding application of these results to children.
“Although this study found no serious adverse events among the populations studied, we need further research into the significance of the results and the safety and efficacy of probiotics in children, notably those with weakened immune systems,” says Professor Upton Allen (Department of Paediatrics and the Institute of Health Policy, Management and Evaluation), Chief, Division of Infectious Diseases, and Senior Associate Scientist at SickKids.
Probiotic powder and capsules as well as yogurt were included in the studies analyzed. “The results appeared to be even more pronounced when several probiotic organisms were used together,” says Johnston.
When broad-spectrum antibiotics are prescribed to treat and prevent infections the medications can also destroy necessary bacteria in the colon. Probiotics help to reintroduce healthy bacteria. “That’s why probiotics could be an effective, safe and relatively inexpensive approach to prevent C. difficile-associated diarrheal illness in adult patients whose immune systems are not compromised,” adds Johnston.
For more information, please contact:
Polly Thompson The Hospital for Sick Children Toronto, Ontario, Canada 416-813-7654 ext. 2059; polly.thompson@sickkids.ca
Matet Nebres The Hospital for Sick Children Toronto, Ontario, Canada 416-813-6380; matet.nebres@sickkids.ca
