Scientist - News - 19-11-2008:

New UK research into probiotics as diarrhoea prevention
Beintema, Nienke

A coalition of five British hospitals will study the effect of several strains of probiotics on antibiotic-associated diarrhoea, including diarrhoea caused by Clostridium difficile.

The project, which will be concluded in 2011, will be funded by the UK National Institute of Health Research. It will be a randomised, double-blind, controlled trial, conducted in five hospitals in the UK.
"There is a reasonable body of evidence that suggests that probiotics are helpful in preventing antibiotic-associated diarrhoea," reacts lead researcher Stephen Allen of Swansea University’s School of Medicine by email. "However, there is insufficient evidence to inform clinical practice, and also regarding the cost-effectiveness of this approach. We hope that our study will directly address these issues."

Elderly people
Antibiotics disturb the natural balance of bacteria in the digestive tract. This renders the patient vulnerable to infections with pathogens, such as C. difficile. Antibiotic-associated diarrhoea, as Allen points out, is generally not a serious illness, but nevertheless very distressing and troublesome for elderly people whose mobility is often restricted. "We will focus on C. difficile, because this is a common and potentially dangerous pathogen that can result in severe diarrhoeal illness and even death."
Approximately one third of all elderly hospital patients receive antibiotics. One fifth of them, or 6% of the elderly that are hospitalized, develop diarrhoea because of this. Diarrhoea delays the recovery process, which may significantly increase the cost of the hospital treatment. A C. difficile infection easily amounts to an extra € 5000 cost, according to a British estimate.
The coalition will study four strains of live bacteria of human origin: two strains of Lactobacillus acidophilus, one of Bifidobacterium bifidum and one of B. lactis. The probiotics will be administered as a powder in capsules containing 60 billion organisms per capsule.
"There is some preliminary evidence of effectiveness of these organisms against C. difficile," continues Allen. "We believe that a multi-strain preparation with a high number of organisms is likely to be the best way to prevent antibiotic-associated diarrhoea, including C. difficile diarrhoea."


More information:
Press release from Swansea University