title: Saccharomyces boulardii for the prevention of hospital onset Clostridium difficile infection.
abstract: OBJECTIVE
  Probiotics, including Saccharomyces boulardii, have been advocated for the prevention of Clostridium difficile infection. The aim of this project was to evaluate the effects of the removal of S. boulardii from an automatic antibiotic order set and hospital formulary on hospital onset C. difficile infection rates.
  
  
  METHODS
  A retrospective chart review was performed on all patients with hospital onset C. difficile infection during the 13 months prior (control group) and the 13 months after (study group) removal of an automatic order set linking S. boulardii capsules to certain broad spectrum antibiotics.
  
  
  METHODS
  A large 800+ bed tertiary hospital.
  
  
  RESULTS
  Among all hospitalized patients, the rate of hospital onset C. difficile infection was 0.99 per 1000 patient days while the S. boulardii protocol was active compared with 1.04 per 1000 patient days (p=0.10) after S. boulardii was removed from the formulary. No difference in the rate of hospital onset C. difficile infection was detected in patients receiving the linked broad spectrum antibiotics during and after the removal of the protocol (1.25% vs. 1.51%, respectively; p=0.70).
  
  
  CONCLUSIONS
  Removal of S. boulardii administration to patients receiving broad spectrum antibiotics and the hospital formulary did not impact the rate of hospital onset C. difficile infection in either the hospital population or patients receiving broad spectrum antibiotics.
authors.affiliation: University of Connecticut School of Pharmacy, Storrs, CT, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Flatley
authors.affiliation: Norton Healthcare Department of Pharmacy, Louisville, KY, USA.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Wilde
authors.affiliation: University of Connecticut School of Pharmacy, Storrs; Hartford Hospital, Hartford, CT, USA. Michael.Nailor@hhchealth.org.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Nailor
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016360:Clostridioides difficile / Q000472:pathogenicity*; D003237:Connecticut; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D012440:Saccharomyces / Q000145:classification / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents