Effect of lactobacillus casei shirota in preventing antibiotic associated diarrhoea including clostridium difficile infection in patients with spinal cord injuries: a multicentre randomised, double-blinded, placebo-controlled trial

2021 ◽  
Vol 46 ◽  
pp. S548-S549
Author(s):  
S. Wong ◽  
S.P. Hirani ◽  
A. Forbes ◽  
N. Kumar ◽  
R. Hariharan ◽  
...  
2013 ◽  
Vol 111 (4) ◽  
pp. 672-678 ◽  
Author(s):  
Samford Wong ◽  
Ali Jamous ◽  
Jean O'Driscoll ◽  
Ravi Sekhar ◽  
Mike Weldon ◽  
...  

Certain probiotics may prevent the development of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD), but their effectiveness depends on both strain and dose. There are few data on nutritional interventions to control AAD/CDAD in the spinal cord injury (SCI) population. The present study aimed to assess (1) the efficacy of consuming a commercially produced probiotic containing at least 6·5 × 109 live Lactobacilluscasei Shirota (LcS) in reducing the incidence of AAD/CDAD, and (2) whether undernutrition and proton pump inhibitors (PPI) are risk factors for AAD/CDAD. A total of 164 SCI patients (50·1 (sd 17·8) years) with a requirement for antibiotics (median 21 d, range 5–366) were randomly allocated to receive LcS (n 76) or no probiotic (n 82). LcS was given once daily for the duration of the antibiotic course and continued for 7 days thereafter. Nutritional risk was assessed by the Spinal Nutrition Screening Tool. The LcS group had a significantly lower incidence of AAD (17·1 v. 54·9 %, P< 0·001). At baseline, 65 % of patients were at undernutrition risk. Undernutrition (64·1 v. 33·3 %, P< 0·01) and the use of PPI (38·4 v. 12·1 %, P= 0·022) were found to be associated with AAD. However, no significant difference was observed in nutrient intake between the groups. The multivariate logistic regression analysis identified poor appetite ( < 1/2 meals eaten) (OR 5·04, 95 % CI 1·28, 19·84) and no probiotic (OR 8·46, 95 % CI 3·22, 22·20) as the independent risk factors for AAD. The present study indicated that LcS could reduce the incidence of AAD in hospitalised SCI patients. A randomised, placebo-controlled study is needed to confirm this apparent therapeutic success in order to translate into improved clinical outcomes.


2020 ◽  
Vol 12 (11) ◽  
pp. 4439 ◽  
Author(s):  
Nicoleta Negrut ◽  
Delia Carmen Nistor-Cseppento ◽  
Shamim Ahmad Khan ◽  
Carmen Pantis ◽  
Teodor Andrei Maghiar ◽  
...  

Clostridium difficile infection (CDI) is the most common infectious disease related to antibiotic-associated diarrhoea and is a current leading cause of morbidity/mortality, with substantial consequences for healthcare services and overall public health. Thus, we performed a retrospective epidemiological study of CDI for a long period (8 years), in an infectious hospital located in north-western Romania, which serves an entire county of the country (617,827 inhabitants). From 2011 to 2018, 877 patients were diagnosed with CDI; the mean incidence of this disease was 2.76 cases/10,000 patient-days, with an increasing trend in the annual incidence until 2016, at which point there was a decrease. The most commonly afflicted were patients in the 75–84 age group, observed in winter and spring. The results show that the antibiotics were administered in 679 (77.42%) subjects, within the last 3 months before CDI, statistically significant more than proton-pump inhibitors (PPIs)—128 (14.60%) and antidepressant medications—60 (6.84%), which were administered during the same period (p < 0.001). No medication was reported in 10 (6.84%) cases of CDI, in the last 3 months of the study. The fatality rate attained 4.1%, tripling in 2018 vs. 2011. CDI became a significant public health conundrum that can, nevertheless, be combatted through a judicious use of antibiotics.


2014 ◽  
Vol 42 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Swetha Ramanathan ◽  
Stuart Johnson ◽  
Stephen P. Burns ◽  
Stephen M. Kralovic ◽  
Barry Goldstein ◽  
...  

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