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Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children

  1. Joshua Z Goldenberg1,
  2. Stephanie SY Ma2,
  3. Jane D Saxton1,
  4. Mark R Martzen3,
  5. Per O Vandvik4,
  6. Kristian Thorlund5,
  7. Gordon H Guyatt5,
  8. Bradley C Johnston6,7,*

Editorial Group: Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group

Published Online: 31 MAY 2013

Assessed as up-to-date: 21 FEB 2013

DOI: 10.1002/14651858.CD006095.pub3


How to Cite

Goldenberg JZ, Ma SSY, Saxton JD, Martzen MR, Vandvik PO, Thorlund K, Guyatt GH, Johnston BC. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. DOI: 10.1002/14651858.CD006095.pub3.

Author Information

  1. 1

    Bastyr University, Seattle, WA, USA

  2. 2

    McMaster University, Division of Plastic & Reconstructive Surgery, Hamilton, Ontario, Canada

  3. 3

    Bastyr University, Bastyr University Research Institute, Kenmore, WA, USA

  4. 4

    Norwegian Knowledge Centre for the Health Services, Oslo, Norway

  5. 5

    McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada

  6. 6

    The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada

  7. 7

    University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada

*Bradley C Johnston, bradley.johnston@sickkids.ca. bjohnst@mcmaster.ca.

Publication History

  1. Publication Status: New
  2. Published Online: 31 MAY 2013

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[Figure 1]
Figure 1. Flow of studies diagram.
[Figure 2]
Figure 2. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Blanks cells indicate that this outcome was not assessed in the study.
[Figure 3]
Figure 3. Forest plot of comparison: 1 C. difficile associated diarrhea, outcome: 1.1 Incidence CDAD: complete case.
[Figure 4]
Figure 4. Forest plot of comparison: 2 Adverse events, outcome: 2.1 Adverse Events: complete case.
[Figure 5]
Figure 5. Funnel plot of comparison: 1 C. difficile associated diarrhea, outcome: 1.1 Incidence CDAD: complete case.
[Figure 6]
Figure 6. Contour enhanced funnel plot for CDAD. The white area represents where a future trial would have to lay for the effect estimate to no longer be statistically significant.
[Analysis 1.1]
Analysis 1.1. Comparison 1 C. difficile associated diarrhea, Outcome 1 Incidence CDAD: complete case.
[Analysis 1.2]
Analysis 1.2. Comparison 1 C. difficile associated diarrhea, Outcome 2 Incidence CDAD: complete case - fixed effects.
[Analysis 1.3]
Analysis 1.3. Comparison 1 C. difficile associated diarrhea, Outcome 3 Incidence CDAD Sensitivity (1.5:1).
[Analysis 1.4]
Analysis 1.4. Comparison 1 C. difficile associated diarrhea, Outcome 4 Incidence CDAD Sensitivity (2:1).
[Analysis 1.5]
Analysis 1.5. Comparison 1 C. difficile associated diarrhea, Outcome 5 Incidence CDAD Sensitivity (3:1).
[Analysis 1.6]
Analysis 1.6. Comparison 1 C. difficile associated diarrhea, Outcome 6 Incidence CDAD Sensitivity (5:1).
[Analysis 1.7]
Analysis 1.7. Comparison 1 C. difficile associated diarrhea, Outcome 7 Incidence CDAD: Subgroup: Inpatient versus outpatient populations.
[Analysis 1.8]
Analysis 1.8. Comparison 1 C. difficile associated diarrhea, Outcome 8 Incidence CDAD: Subgroup: Species: all.
[Analysis 1.9]
Analysis 1.9. Comparison 1 C. difficile associated diarrhea, Outcome 9 Incidence CDAD: Subgroup: Species: LGG versus SB.
[Analysis 1.10]
Analysis 1.10. Comparison 1 C. difficile associated diarrhea, Outcome 10 Incidence CDAD: Subgroup: Species: LGG versus LA + LC.
[Analysis 1.11]
Analysis 1.11. Comparison 1 C. difficile associated diarrhea, Outcome 11 Incidence CDAD: Subgroup: Risk of Bias.
[Analysis 1.12]
Analysis 1.12. Comparison 1 C. difficile associated diarrhea, Outcome 12 Incidence CDAD: Subgroup: Adult versus child.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Adverse events, Outcome 1 Adverse Events: complete case.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Adverse events, Outcome 2 Adverse Events: Subgroup: Risk of Bias.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Adverse events, Outcome 3 AE Sensitivity 1.5:1.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Adverse events, Outcome 4 AE Sensitivity 2:1.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Adverse events, Outcome 5 AE Sensitivity 3:1.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Adverse events, Outcome 6 AE Sensitivity 5:1.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Incidence of Clostridium difficile infection, Outcome 1 Incidence of infection: complete case.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Incidence of Clostridium difficile infection, Outcome 2 Incidence of infection: Subgroup: Risk of Bias.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Length of hospital stay, Outcome 1 Length of Hospital Stay: complete case.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Antibiotic associated diarrhea, Outcome 1 Incidence AAD: complete case.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Antibiotic associated diarrhea, Outcome 2 Incidence AAD: Subgroup: Risk of Bias.
[Analysis 5.3]
Analysis 5.3. Comparison 5 Antibiotic associated diarrhea, Outcome 3 Incidence AAD: sensitivity (1.5:1).
[Analysis 5.4]
Analysis 5.4. Comparison 5 Antibiotic associated diarrhea, Outcome 4 Incidence AAD: sensitivity (2:1).
[Analysis 5.5]
Analysis 5.5. Comparison 5 Antibiotic associated diarrhea, Outcome 5 Incidence AAD: sensitivity (3:1).
[Analysis 5.6]
Analysis 5.6. Comparison 5 Antibiotic associated diarrhea, Outcome 6 Incidence AAD: sensitivity (5:1).
[Analysis 5.7]
Analysis 5.7. Comparison 5 Antibiotic associated diarrhea, Outcome 7 Patient population.
[Analysis 5.8]
Analysis 5.8. Comparison 5 Antibiotic associated diarrhea, Outcome 8 Species: all.
[Analysis 5.9]
Analysis 5.9. Comparison 5 Antibiotic associated diarrhea, Outcome 9 Species: LGG versus SB.
[Analysis 5.10]
Analysis 5.10. Comparison 5 Antibiotic associated diarrhea, Outcome 10 Species: LGG versus LA + LC.
[Analysis 5.11]
Analysis 5.11. Comparison 5 Antibiotic associated diarrhea, Outcome 11 Adult versus child.