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Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review

Department of Medicinal Chemistry, University of Washington, VA Puget Sound Healthcare System, 1660 S. Columbian Way, S-152, Seattle, WA 98108, USA
Academic Editor: Yung-Fu Chang
Antibiotics 2015, 4(2), 160-178; https://doi.org/10.3390/antibiotics4020160
Received: 9 March 2015 / Accepted: 2 April 2015 / Published: 13 April 2015
(This article belongs to the Special Issue Clostridium difficile Infection)
Clostridium difficile infections are a global clinical concern and are one of the leading causes of nosocomial outbreaks. Preventing these infections has benefited from multidisciplinary infection control strategies and new antibiotics, but the problem persists. Probiotics are effective in preventing antibiotic-associated diarrhea and may also be a beneficial strategy for C. difficile infections, but randomized controlled trials are scarce. This meta-analysis pools 21 randomized, controlled trials for primary prevention of C. difficile infections (CDI) and four trials for secondary prevention of C. difficile recurrences and assesses the efficacy of specific probiotic strains. Four probiotics significantly improved primary CDI prevention: (Saccharomyces boulardii, Lactobacillus casei DN114001, a mixture of L. acidophilus and Bifidobacterium bifidum, and a mixture of L. acidophilus, L. casei and L. rhamnosus). None of the tested probiotics significantly improved secondary prevention of CDI. More confirmatory randomized trials are needed to establish if probiotics are useful for preventing C. difficile infections. v View Full-Text
Keywords: probiotics; clostridium difficile infections; diarrhea; meta-analysisv probiotics; clostridium difficile infections; diarrhea; meta-analysisv
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McFarland, L.V. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review. Antibiotics 2015, 4, 160-178.

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