Commercially available probiotic drinks containing Lactobacillus casei DN-114001 reduce antibiotic-associated diarrhea.
OBJECTIVE
To investigate the effect of Lactobacillus-containing commercially available probiotic formulations in Germany during antibiotic treatment with an analysis of cost-efficiency.


METHODS
In an observational study, we analyzed the frequency of bowel movements from 258 patients with infections in a primary care hospital in western Germany; 107 of the patients were offered a probiotic drink containing at least 10 billion cultures of Lactobacillus casei DN 114001 b.i.d. The economic analysis was based on the costs of patient isolation vs preventive intake of probiotics. In a second pilot study, two commercially available probiotic drinks with different Lactobacillus casei strains were directly compared in 60 patients in a randomized controlled fashion.


RESULTS
In the first study, the incidence of antibiotic-associated diarrhea (AAD) was significantly reduced in the intervention group (6.5% vs 28.4%), and the duration of AAD in days was significantly shorter (1.7 ± 1.1 vs 3.1 ± 2.1). Higher age and creatinine and lower albumin were identified as risk factors for AAD. Ampicillin was the antibiotic with the highest rate of AAD (50%) and with the greatest AAD reduction in the probiotic group (4.2%, relative risk reduction 92%). The economic analysis showed a cost advantage of nearly 60000 €/year in a department of this size. The second study confirmed the preventive effect of the drink with Lactobacillus casei DN114001; however, there were no advantages found for the other tested probiotic drink containing Lactobacillus casei Shirota.


CONCLUSIONS
In contrast to a drink containing Lactobacillus casei Shirota, a commercially available probiotic drink containing Lactobacillus casei DN 114001 cost-efficiently reduces the prevalence of AAD during antibiotic treatment.
Christoph G Dietrich, Manuela Alavi, Department of Medicine, Bethlehem Hospital, Teaching Hospital of Aachen University RWTH, 52222 Stolberg, Rhineland, Germany.
Christoph G
CG
Dietrich
Christoph G Dietrich, Manuela Alavi, Department of Medicine, Bethlehem Hospital, Teaching Hospital of Aachen University RWTH, 52222 Stolberg, Rhineland, Germany.
Tanja
T
Kottmann
Christoph G Dietrich, Manuela Alavi, Department of Medicine, Bethlehem Hospital, Teaching Hospital of Aachen University RWTH, 52222 Stolberg, Rhineland, Germany.
Manuela
M
Alavi
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001628:Beverages / Q000191:economics / Q000382:microbiology*; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000139:chemically induced / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007780:Lacticaseibacillus casei / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019936:Probiotics / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Antibiotics-associated diarrhea; Lactobacillus casei; Probiotics