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Nutrients 2018, 10(5), 539; https://doi.org/10.3390/nu10050539

Feasibility of a Lactobacillus casei Drink in the Intensive Care Unit for Prevention of Antibiotic Associated Diarrhea and Clostridium difficile

1
Alberta Health Services, 670 CSC Royal Alexandra Hospital, Edmonton, AB T5H 3V9, Canada
2
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, Edmonton, AB T5H 3V9, Canada
3
Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T5H 3V9, Canada
*
Author to whom correspondence should be addressed.
Received: 29 March 2018 / Revised: 17 April 2018 / Accepted: 20 April 2018 / Published: 26 April 2018
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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Abstract

Background: Over 70% of patients are prescribed antibiotics during their intensive care (ICU) admission. The gut microbiome is dramatically altered early in an ICU stay, increasing the risk for antibiotic associated diarrhea (AAD) and Clostridium difficile infections (CDI). Evidence suggests that some probiotics are effective in the primary prevention of AAD and CDI. Aim: To demonstrate safety and feasibility of a probiotic drink in ICU patients. Methods: ICU patients initiated on antibiotics were recruited, and matched with contemporary controls. Study patients received two bottles daily of a drink containing 10 billion Lactobacillus casei which was bolused via feeding tube. Tolerance to probiotics and enteral nutrition, development of adverse events, and incidence of AAD was recorded. CDI rates were followed for 30 days post antibiotic treatment. Results: Thirty-two patients participated in the trial. There were no serious adverse events in the probiotic group, compared to three in the control group. AAD was documented in 12.5% of the probiotic group and 31.3% in the control group. One patient in the probiotic group developed CDI compared to three in the control group. Discussion: A probiotic containing drink can safely be delivered via feeding tube and should be considered as a preventative measure for AAD and CDI in ICU. View Full-Text
Keywords: ICU; diarrhea; Clostridium difficile; Lactobacillus casei drink ICU; diarrhea; Clostridium difficile; Lactobacillus casei drink
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Alberda, C.; Marcushamer, S.; Hewer, T.; Journault, N.; Kutsogiannis, D. Feasibility of a Lactobacillus casei Drink in the Intensive Care Unit for Prevention of Antibiotic Associated Diarrhea and Clostridium difficile. Nutrients 2018, 10, 539.

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