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Maziade reports that he is a member of the Scientific Advisory Board of Bio-K Plus International. In the study you will find all relevant financial information from all other authors.
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The rate of hospital-acquired Clostridioides difficile infection improved 39% in a Quebec hospital when 70% of antibiotic users took a three-strain lactobacillus probiotic according to a pharmacy-controlled protocol, researchers reported.
Among those who took the probiotic with multiple antibiotics or a single high-risk antibiotic, the incidence of CDI decreased by at least half, according to results published in Clinical Infectious Diseases.
Using a probiotic containing three strains of Lactobacillus significantly improved the rate of health care-related Clostridioides difficile infections.
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“We decided to conduct massive primary prevention of CDI with a probiotic in a hospital that has had an endemic CDI problem for more than 20 years.” Pierre-Jean Maziade, MD, said Healio, clinical advisor in the Microbiology and Infectious Diseases Division of the Lanaudière Integrated Health and Social Services Center.
As of 2016, the hospital restricted its use of quinolone antibiotics and replaced azithromycin with doxycycline as the main treatment for community-acquired pneumonia, Maziade and a colleague reported. According to the study, on October 16, 2017, the hospital implemented a clinical order set for the probiotic preparation with three strains. Adult inpatients who were prescribed antibiotics for 2 or more days were marked to receive the probiotic for the first 24 hours daily.
Pierre-Jean Maziade
According to the study, eligible adults consumed up to two capsules of a probiotic made from Lactobacillus acidophilus CL1285, Lacticaseibacillus (Lactobacillus) casei LBC80R, and Lacticaseibacillus (Lactobacillus) rhamnosus CLR2 daily throughout antibiotic treatment, and for a further 5 days after therapy. Electronic pharmacy records were collected for all antibiotic or probiotic prescriptions for adult inpatients treated in hospital from October 16, 2016 to March 31, 2019, and patients with at least three loose stools daily who showed signs of possible CDI. provided stool samples to the hospital’s microbiological laboratory for C. difficile toxin A and toxin B tests using enzyme immunoassay.
In total, records were identified for 13,922 adult inpatient visits for whom antibiotics were prescribed, corresponding to 4,383 patients in the 12-month observation period and 6,079 patients in the 18-month intervention period.
The study showed that the hospital-acquired Clostridioides difficile infection rate (HA-CDI) was significantly lower during the intervention. 5.2 cases per 10,000 patient days compared to 8.6 (P = 0.002). The proportion of HA-CDI cases with relapses remained similar at 16 (19%) during the observation period and 13 (16%) during the intervention, although the researchers found that a lower proportion of probiotics-treated patients had relapses (six) or 13% versus seven or 25%).
In addition, the incidence of HA-CDI in antibiotic users decreased significantly by 0.9% during the intervention, compared with 1.5% during the observation period. Without considering the different risk of eligible patients, the incidence of HA-CDI was similar when taking the probiotic (OR = 0.69).
According to Maziade and colleagues, patients exposed to multiple antibiotics per visit had a lower incidence of HA-CDI with the probiotic (OR = 0.5) when riskier antibiotic courses were prescribed.
“The probiotic is safe and inexpensive. A case of CDI can cost up to $ 25,000 and is strain specific,” said Maziade. “This probiotic inhibits the growth, toxin production and sporulation of C. difficile.”
Other studies have shown that probiotics did not reduce the rate of C difficile in the facility in patients taking antibiotics.
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