Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults—A meta-analysis
Version of Record online: 27 APR 2011
©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners
Journal of the American Academy of Nurse Practitioners
Volume 23, Issue 6, pages 269–274, June 2011
How to Cite
Avadhani, A. and Miley, H. (2011), Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults—A meta-analysis. Journal of the American Academy of Nurse Practitioners, 23: 269–274. doi: 10.1111/j.1745-7599.2011.00617.x
The authors report no competing interests.
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- Issue online: 7 JUN 2011
- Version of Record online: 27 APR 2011
- Received: October 2009;, accepted: September 2010
- antibiotic use;
Purpose: A serious complication associated with the use of most antibiotics is antibiotic-associated diarrhea (AAD). The purpose of this article is to report findings from a meta-analysis of available studies on adult hospitalized populations to evaluate efficacy of probiotics for prevention of AAD and Clostridium difficile-associated disease (CDAD).
Data sources: A comprehensive, systematic search was conducted to identify all relevant studies on probiotic efficacy for prevention of AAD and CDAD. Data synthesis was done using MAStARI software from the Joanna Briggs Institute (University of Adelaide, Australia).
Conclusions: AAD affects one in five people on antibiotics. Risk factors for the development of AAD include the use of broad-spectrum antibiotics and host factors such as age, health status, hospitalization status, and exposure to nosocomial pathogens. About a third of AAD cases have CDAD. Meta-analysis showed that administration of probiotics led to a statistically significant relative risk reduction of 44% for AAD and 71% for CDAD.
Implications for practice: Extended hospital stays, readmissions, and higher hospital costs are just some of the consequences of ADD and CDAD. Strategies currently used include discontinuing or changing the inciting antibiotic, restricting high-risk antibiotics, and encouraging the use of antibiotics based on sensitivity reports. Healthcare spending, morbidity, and mortality can potentially be reduced considerably by reducing the occurrence of ADD and CDAD by administering prophylaxis with probiotics concurrently with antibiotics.