title: A randomized, double-blind, placebo-controlled pilot study of Lactobacillus reuteri ATCC 55730 for the prevention of antibiotic-associated diarrhea in hospitalized adults.
abstract: OBJECTIVE
  The purpose of the study was to evaluate Lactobacillus reuteri for the prevention of antibiotic-associated diarrhea (AAD) in hospitalized adults.
  
  
  BACKGROUND
  AAD is a problem in hospitalized adults, contributing to increased length of stay, cost, and mortality. Probiotics have been proposed as a way to prevent AAD. L. reuteri decreases acute infectious diarrhea in children; however, L. reuteri has never been evaluated for the prevention of AAD.
  
  
  METHODS
  In a randomized, double-blind, placebo-controlled pilot study, in-patients receiving antibiotics were given L. reuteri 1×10 colony-forming units twice daily or an identical placebo for 4 weeks. Stool frequency, consistency, and gastrointestinal symptoms were monitored during the 4-week treatment period and during a 2-week follow-up period.
  
  
  RESULTS
  A total of 31 patients were enrolled. Eight patients were excluded in the data analysis because of length of study participation less than 14 days. Mean age was 51 ± 18 years; 63% were female and 37% male. Most frequent primary diagnosis was pneumonia (20%), followed by abscess (10%), chronic obstructive pulmonary disease (6.7%), and bronchitis (6.7%). Thirteen patients received L. reuteri and 10 received placebo. Patients treated with L. reuteri had a significantly lower frequency of diarrhea compared with placebo (50% in the placebo group vs. 7.7% in the probiotic group, P=0.02). There were no differences in the frequency or severity of gastrointestinal symptoms.
  
  
  CONCLUSIONS
  In this placebo-controlled, pilot study, L. reuteri twice daily for 4 weeks significantly decreased AAD among hospitalized adults. L. reuteri was safe and well tolerated.
authors.affiliation: Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA. lisa.cimperman@uhhospitals.org
authors.forename: Lisa
authors.initials: L
authors.lastname: Cimperman
authors.forename: Gina
authors.initials: G
authors.lastname: Bayless
authors.forename: Kathleen
authors.initials: K
authors.lastname: Best
authors.forename: Autumn
authors.initials: A
authors.lastname: Diligente
authors.forename: Beth
authors.initials: B
authors.lastname: Mordarski
authors.forename: Melanie
authors.initials: M
authors.lastname: Oster
authors.forename: Meghann
authors.initials: M
authors.lastname: Smith
authors.forename: Felicia
authors.initials: F
authors.lastname: Vatakis
authors.forename: Dawn
authors.initials: D
authors.lastname: Wiese
authors.forename: Alison
authors.initials: A
authors.lastname: Steiber
authors.forename: Jeffry
authors.initials: J
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D052200:Limosilactobacillus reuteri; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents