Display options
Cite
Ehrhardt S, Guo N, Hinz R, et al. Saccharomyces boulardii to Prevent Antibiotic-Associated Diarrhea: A Randomized, Double-Masked, Placebo-Controlled Trial. Open Forum Infect Dis. 2016;3(1):ofw011doi: 10.1093/ofid/ofw011.
Ehrhardt, S., Guo, N., Hinz, R., Schoppen, S., May, J., Reiser, M., Schroeder, M. P., Schmiedel, S., Keuchel, M., Reisinger, E. C., Langeheinecke, A., de Weerth, A., Schuchmann, M., Schaberg, T., Ligges, S., Eveslage, M., Hagen, R. M., Burchard, G. D., & Lohse, A. W. (2016). Saccharomyces boulardii to Prevent Antibiotic-Associated Diarrhea: A Randomized, Double-Masked, Placebo-Controlled Trial. Open forum infectious diseases, 3(1), ofw011. https://doi.org/10.1093/ofid/ofw011
Ehrhardt, Stephan, et al. "Saccharomyces boulardii to Prevent Antibiotic-Associated Diarrhea: A Randomized, Double-Masked, Placebo-Controlled Trial." Open forum infectious diseases vol. 3,1 (2016): ofw011. doi: https://doi.org/10.1093/ofid/ofw011
Ehrhardt S, Guo N, Hinz R, Schoppen S, May J, Reiser M, Schroeder MP, Schmiedel S, Keuchel M, Reisinger EC, Langeheinecke A, de Weerth A, Schuchmann M, Schaberg T, Ligges S, Eveslage M, Hagen RM, Burchard GD, Lohse AW. Saccharomyces boulardii to Prevent Antibiotic-Associated Diarrhea: A Randomized, Double-Masked, Placebo-Controlled Trial. Open Forum Infect Dis. 2016 Jan 29;3(1):ofw011. doi: 10.1093/ofid/ofw011. eCollection 2016 Jan. PMID: 26973849; PMCID: PMC4785405.
Copy Download .nbib Format: NLM
Share it on

Open Forum Infect Dis. 2016 Jan 29;3(1):ofw011. doi: 10.1093/ofid/ofw011. eCollection 2016 Jan.

Saccharomyces boulardii to Prevent Antibiotic-Associated Diarrhea: A Randomized, Double-Masked, Placebo-Controlled Trial.

Open forum infectious diseases

Stephan Ehrhardt, Nan Guo, Rebecca Hinz, Stefanie Schoppen, Jürgen May, Markus Reiser, Maximilian Philipp Schroeder, Stefan Schmiedel, Martin Keuchel, Emil C Reisinger, Andreas Langeheinecke, Andreas de Weerth, Marcus Schuchmann, Tom Schaberg, Sandra Ligges, Maria Eveslage, Ralf M Hagen, Gerd D Burchard, Ansgar W Lohse

Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine.
  2. Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
  3. Department of Tropical Medicine at the Bernhard Nocht Institute , German Armed Forces Hospital of Hamburg.
  4. Clinical Research Unit , Bernhard Nocht Institute for Tropical Medicine.
  5. Infectious Disease Epidemiology , Bernhard Nocht Institute for Tropical Medicine.
  6. Department of Medicine II , Klinikum Vest GmbH , Marl.
  7. Department of Internal Medicine , Federal Armed Forces Hospital Ulm.
  8. Department of Medicine I , University Medical Center Hamburg-Eppendorf.
  9. Bethesda Krankenhaus Bergedorf, Klinik fur Innere Medizin.
  10. Department of Internal Medicine, Division for Tropical Medicine and Infectious Diseases , Rostock University Medical Center.
  11. Medical Clinic I , Hospital of Saarbrücken.
  12. Department of Internal Medicine , Agaplesion Diakonieklinikum Hamburg.
  13. I. Department of Internal Medicine, Johannes-Gutenberg-Universität Mainz, University Medical Centre; I. Department of Internal Medicine, Constance Hospital.
  14. Diakoniekrankenhaus Rotenburg (Wümme) GmbH, Zentrum für Pneumologie.
  15. Institute of Biostatistics and Clinical Research , University of Münster.
  16. Department of Medicine I, University Medical Center Hamburg-Eppendorf; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.

PMID: 26973849 PMCID: PMC4785405 DOI: 10.1093/ofid/ofw011

Abstract

Background.  Antibiotic-associated diarrhea (AAD) and Clostridium difficile-associated diarrhea (CDAD) are common complications of antibiotic use. Data on the efficacy of probiotics to prevent AAD and CDAD are unclear. We aimed to evaluate the efficacy of Saccharomyces boulardii to prevent AAD and CDAD in hospitalized adult patients. Methods.  We conducted a multicenter, phase III, double-masked, randomized, placebo-controlled trial in hospitalized patients who received systemic antibiotic treatment in 15 hospitals in Germany between July 2010 and October 2012. Participants received Perenterol forte 250 mg capsules or matching placebo twice per day within 24 hours of initiating antibiotic treatment, continued treatment for 7 days after antibiotic discontinuation, and were then observed for 6 weeks. Results.  Two thousand four hundred forty-four patients were screened. The trial was stopped early for futility after inclusion of 477 participants. Two hundred forty-six patients aged 60.1 ± 16.5 years and 231 patients aged 56.5 ± 17.8 were randomized to the S boulardii group and the placebo group, respectively, with 21 and 19 AADs in the respective groups (P = .87). The hazard ratio of AAD in the S boulardii group compared with the placebo group was 1.02 (95% confidence interval, .55-1.90; P = .94). Clostridium difficile-associated diarrhea occurred in 0.8% of participants (4 of 477). Nine serious adverse events were recorded in the S boulardii group, and 3 serious adverse events were recorded in the placebo group. None were related to study participation. Conclusions.  We found no evidence for an effect of S boulardii in preventing AAD or CDAD in a population of hospitalized patients without particular risk factors apart from systemic antibiotic treatment. ClinicalTrials.gov Identifier.  NCT01143272.

Keywords: Clostridium difficile-associated diarrhea; Saccharomyces boulardii; antibiotic-associated diarrhea; probiotic; randomized controlled trial

References

  1. Cochrane Database Syst Rev. 2013 May 31;(5):CD006095 - PubMed
  2. J Intern Med. 2005 Jan;257(1):78-92 - PubMed
  3. Aliment Pharmacol Ther. 2005 Sep 1;22(5):365-72 - PubMed
  4. Dig Dis. 1998 Sep-Oct;16(5):292-307 - PubMed
  5. Am J Gastroenterol. 2006 Apr;101(4):812-22 - PubMed
  6. BMJ. 2007 Jul 14;335(7610):80 - PubMed
  7. Ann Intern Med. 2012 Dec 18;157(12):878-88 - PubMed
  8. Am J Clin Nutr. 2010 Mar;91(3):687-703 - PubMed
  9. Am J Gastroenterol. 2012 Jun;107(6):922-31 - PubMed
  10. Clin Infect Dis. 2002 Feb 1;34(3):346-53 - PubMed
  11. JAMA. 2012 May 9;307(18):1959-69 - PubMed
  12. Lancet. 2013 Oct 12;382(9900):1249-57 - PubMed
  13. Am J Health Syst Pharm. 2001 Jun 15;58(12):1101-9 - PubMed
  14. J Clin Gastroenterol. 2011 Nov;45 Suppl:S149-53 - PubMed
  15. Clin Infect Dis. 2015 May 15;60 Suppl 2:S85-90 - PubMed
  16. Antimicrob Agents Chemother. 2011 Apr;55(4):1494-503 - PubMed
  17. Lancet Infect Dis. 2006 Jun;6(6):374-82 - PubMed
  18. Am J Gastroenterol. 2010 Jul;105(7):1636-41 - PubMed
  19. Aliment Pharmacol Ther. 2012 Jun;35(12):1355-69 - PubMed
  20. Int J Antimicrob Agents. 2000 Dec;16(4):521-6 - PubMed
  21. Stat Med. 2004 Aug 30;23(16):2497-508 - PubMed
  22. N Engl J Med. 2015 Feb 26;372(9):825-34 - PubMed
  23. Z Gastroenterol. 2014 Jun;52(6):549-57 - PubMed
  24. N Engl J Med. 2002 Jan 31;346(5):334-9 - PubMed

Publication Types