Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis
Abstract Objective: To evaluate efficacy of probiotics in prevention and treatment of diarrhoea associated with the use of antibiotics. Design: Meta-analysis; outcome data (proportion of patients not getting diarrhoea) were analysed, pooled, and compared to determine odds ratios in treated and contr...
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Published in | BMJ Vol. 324; no. 7350; pp. 1361 - 1364 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
London
British Medical Journal Publishing Group
08.06.2002
British Medical Association BMJ Publishing Group LTD BMJ |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract Objective: To evaluate efficacy of probiotics in prevention and treatment of diarrhoea associated with the use of antibiotics. Design: Meta-analysis; outcome data (proportion of patients not getting diarrhoea) were analysed, pooled, and compared to determine odds ratios in treated and control groups. Identification: Studies identified by searching Medline between 1966 and 2000 and the Cochrane Library. Studies reviewed Nine randomised, double blind, placebo controlled trials of probiotics. Results: Two of the nine studies investigated the effects of probiotics in children. Four trials used a yeast (Saccharomyces boulardii), four used lactobacilli, and one used a strain of enterococcus that produced lactic acid. Three trials used a combination of probiotic strains of bacteria. In all nine trials, the probiotics were given in combination with antibiotics and the control groups received placebo and antibiotics. The odds ratio in favour of active treatment over placebo in preventing diarrhoea associated with antibiotics was 0.39 (95% confidence interval 0.25 to 0.62; P<0.001) for the yeast and 0.34 (0.19 to 0.61; P<0.01 for lactobacilli. The combined odds ratio was 0.37 (0.26 to 0.53; P<0.001) in favour of active treatment over placebo. Conclusions: The meta-analysis suggests that probiotics can be used to prevent antibiotic associated diarrhoea and that S boulardii and lactobacilli have the potential to be used in this situation. The efficacy of probiotics in treating antibiotic associated diarrhoea remains to be proved. A further large trial in which probiotics are used as preventive agents should look at the costs of and need for routine use of these agents. |
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Bibliography: | ark:/67375/NVC-RH7HBDSG-L href:bmj-324-1361.pdf ArticleID:bmj.324.7350.1361 local:bmj;324/7350/1361 PMID:12052801 istex:D97CD30E78E8BB73730A5DFCE9C4E933C51193CB Correspondence to: A L D'Souza Correspondence to: A L D'Souza aloysius.dsouza@ic.ac.uk Contributors: CJB had the original plan for the meta-analysis, researched individual papers, offered statistical advice, and edited the final paper. AD'S conducted the online and other searches, researched individual papers, extracted output data from individual trials, and wrote the paper. JC was responsible for the statistical analysis, calculated final output data and odds ratios, drew the final graph, and conducted tests of publication bias. CR researched individual papers and assisted in the preparation of the article. |
ISSN: | 0959-8138 0959-8146 1468-5833 1756-1833 |
DOI: | 10.1136/bmj.324.7350.1361 |