Prophylactic Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea: a prospective study.
BACKGROUND
Interest to probiotics for the prevention and treatment of antibiotic-associated diarrhea is increasing gradually. The most promising seems to be Saccharomyces boulardii . Using a double-blind controlled study, we investigated the preventive effect of S. boulardii on the development of antibiotic-associated diarrhea in patients under antibiotherapy but not requiring intensive care therapy.


METHODS
All the patients were hospitalized at the Gulhane Military Medical Academy, Department of Infectious Diseases and Clinical Microbiology. S. boulardii was given twice daily during the course of antibiotic therapy and application was initiated in all patients as late as after 48 hours of antibiotic therapy. A total of 151 patients completed the study.


RESULTS
The antibiotic-associated diarrhea development ratio in placebo group was 9% (7/78) and in the study group 1.4% (1/73) (p < 0.05). Stool samples from the patients with antibiotic-associated diarrhea were stored at -70 degrees C and Clostiridium difficile toxin A assay was performed using Enzyme Immune Assay as late as in seven days. C. difficile toxin A assay yielded positive results in two (2/7) stool samples from the patients with antibiotic-associated diarrhea in the placebo group and a negative result in the only patient who developed antibiotic-associated diarrhea in the study group.


CONCLUSIONS
The results implied that prophylactic use of Saccharomyces boulardii resulted in reduced, with no serious side effects, antibiotic-associated diarrhea in hospitalized patients.
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
Mehmet
M
Can
Bulent Ahmet
BA
Beşirbellioglu
Ismail Yasar
IY
Avci
Can Murat
CM
Beker
Alaaddin
A
Pahsa
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001427:Bacterial Toxins / Q000032:analysis; D016360:Clostridioides difficile / Q000472:pathogenicity; D003967:Diarrhea / Q000139:chemically induced* / Q000209:etiology / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications; D004768:Enterotoxins / Q000032:analysis; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019936:Probiotics; D011446:Prospective Studies; D012440:Saccharomyces
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile