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Probiotics + antibiotics reduces C diff diarrhoea risk

June 07, 2013
A new Cochrane review published at the end of May concludes that probiotics can reduce the risk of diarrhoea and other symptoms due to Clostridium difficile infection in people taking antibiotics. The risk of C diff-associated diarrhoea was reduced by 64% in people who took probiotics with their antibiotics compared to people who were given a placebo with their antibiotics. Dr Vanya Gant, Infectious Diseases specialist at The Physicians’ Clinic welcomes the Cochrane summary: “As a practising microbiologist and physician in Infectious Diseases with a PhD in Cellular Immunology I am delighted, but this news comes as no real surprise to me. We already know from well conducted scientific studies that probiotic organisms can stimulate and modulate the immune system. In addition, many well-conducted clinical trials have shown that probiotics are effective against diarrhoea due to infection or antibiotic treatment.”

What is C difficile?

C difficile is a disease-causing bacterium that is common in hospitals and is present in the large bowel of around 2-5% of the human population. Normally this organism is held in check by a combination of all other ‘healthy’ bacteria in the large bowel as well as the immune system − but it can get out of control, particularly in people who are weak or elderly. The trigger is usually antibiotic treatment for another, unrelated infection. The antibiotic kills of most of the bacteria in the bowel, allowing the more resistant C difficile to overwhelm the gut. This causes diarrhoea, inflammation and bleeding and can be difficult to treat as antibiotics can make the infection worse. C diff infection can be fatal.

What are probiotics?

The term probiotics is a wide-ranging one that is used to describe any food or food supplement that contain bacteria that grow in the large bowel without causing any harm. These ‘good’ bacteria prevent infections and problems caused by pathogenic bacteria such as C difficile. A recent very well conducted double blind placebo controlled trial showed that the probiotic Symprove, which is manufactured within a strict quality control framework, is highly effective in irritable bowel syndrome. “Although more trials are needed, I suspect that this and other high quality probiotic compounds are able to shorten episodes of diarrhoea due to infection. Not only that, they may be able to alleviate the symptoms of irritable bowel syndrome and they could be effective in a variety of other conditions such as inflammatory bowel disease,” Dr Gant says. It may even be that these well characterised probiotics may also help to repopulate the human large bowel with organisms which are not antibiotic resistant. “Most of us already carry these because of the food we eat and the antibiotics we take,” warns Dr Gant.

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