In a meta-analysis of 20 randomized, controlled trials, probiotics reduced risk by 66%.

Clostridium difficile–associated diarrhea (CDAD) is increasing in incidence and severity in North America and Europe. Some studies have suggested that probiotics taken in combination with antibiotics can reduce the risk for antibiotic-induced CDAD.

The current meta-analysis identified 20 eligible trials including 3818 patients. The investigators were interested in the protective effect of any probiotic at any dose. Probiotic species included were Bifidobacterium, Lactobacillus, Streptococcus, and Saccharomyces. The pooled relative risk for CDAD in patients receiving probiotics was 0.34 (95% confidence interval, 0.24–0.49). Probiotic use was not associated with increased risk for adverse events and was effective in both adults and children. The risk reduction was greater in trials that used multiple species (relative risk, 0.25).

CITATION(S):

Johnston BC et al. Probiotics for the prevention of Clostridium difficile–associated diarrhea: A systematic review and meta-analysis. Ann Intern Med 2012 Nov 13; [e-pub ahead of print].