title: Investigation of inpatient probiotic use at an academic medical center.
abstract: OBJECTIVE
  Despite the widespread use of probiotics, there are limited data regarding their safety. The aims of this study were to characterize inpatient probiotic use and to determine the incidence of probiotic-related bloodstream infections due to Lactobacillus acidophilus/Lactobacillus bulgaricus.
  
  
  METHODS
  This study was a two-part retrospective study conducted at a large academic medical center. The first part was the characterization of probiotic use during 2007-2008, which included the type of prescribing provider, choice of probiotic prescribed, indications for use, and presence of potential risk factors for probiotic infection among recipients; the second part was the determination of the incidence of probiotic-related bloodstream infections due to L. acidophilus/L. bulgaricus for September 2000-August 2008.
  
  
  RESULTS
  Probiotic use was uncommon (0.4%). Ninety-six percent of patients received Lactobacillus-based compounds. Use was common in patients at theoretical risk for probiotic infection. The maximum estimated incidence of probiotic-related bacteremia due to L. acidophilus/L. bulgaricus during the 8-year period was 0.2%.
  
  
  CONCLUSIONS
  L. acidophilus/L. bulgaricus probiotic use at our institution appeared to be associated with a minimal risk of probiotic-related infection, even though it was used at a high frequency among inpatients who could be considered at high theoretical risk for probiotic-related bloodstream infection.
authors.affiliation: Division of Infectious Diseases at Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA. jsimkins@med.miami.edu
authors.forename: Jacques
authors.initials: J
authors.lastname: Simkins
authors.forename: Anna
authors.initials: A
authors.lastname: Kaltsas
authors.forename: Brian P
authors.initials: BP
authors.lastname: Currie
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000628:therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007779:Lactobacillus acidophilus; D048668:Lactobacillus delbrueckii; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012306:Risk