Clinical Epidemiology: Probiotics in Preventing AAD in Adults

This clinical epidemiology assignment investigates the efficacy of probiotics in preventing antibiotic-associated diarrhea (AAD) in adults. The student conducted a literature search on PubMed, using specific keywords and filters to identify relevant randomized controlled trials published from 2010 onwards, focusing on human subjects and excluding studies on individuals under 19 years old. The search yielded 27 results, which were narrowed down to 18 after excluding studies on children. Further filtering, including the selection of free full-text articles, resulted in 9 articles. From these, the student selected a study by Selinger et al. (2013) which investigated whether Probiotics VSL#3 prevents antibiotic resistant diarrhea in high risk inpatients. The study found that VSL#3 was linked to a significant reduction in the risk of antibiotic associated diarrhea. The assignment provides a detailed analysis of the chosen study and includes a justification for the selection process, highlighting the search strategy and the criteria used to narrow down the results.

Running head: Clinical Epidemiology
Clinical Epidemiology
Name of the Student
Name of the University
Author Note

1Clinical Epidemiology
Research on the topic: “Are Probiotics efficient in the prevention of antibiotic associated
diarrhea (AAD) in adults?”
Database used: PubMed
Link: http://www.ncbi.nlm.nih.gov/pubmed/
Final Syntax and hits:
((Antibiotic‐associated diarrhea) AND Probiotics) AND Randomized controlled trial
Filters:
Article Type: Randomized Controlled Trial
Publication dates: From 2010
Species: Humans
Search Results: 27
Date: 21 May 2018
Exclusion criteria: Studies done on people below 19 years of age are excluded.
Results:
Serial
No:
Authors Title Journal Year
Published
Volume and page
1 Zhang DM,
Xu BB, Yu L,
Zheng LF,
Chen LP,
Wang W
[A prospective
control study of
Saccharomyces
boulardii in
prevention of
Zhonghua Nei
Ke Za Zhi.
2017 56(6), 398-401

2Clinical Epidemiology
antibiotic-
associated
diarrhea in the
older inpatients].
2 Kabbani TA1,
Pallav K,
Dowd SE3,
Villafuerte-
Galvez J,
Vanga RR,
Castillo NE1,
Hansen J,
Dennis M,
Leffler DA,
Kelly CP
Prospective
randomized
controlled study
on the effects of
Saccharomyces
boulardii CNCM
I-745 and
amoxicillin-
clavulanate or
the combination
on the gut
microbiota of
healthy
volunteers.
Gut Microbes 2017 8(1):17-32
3 Evans M,
Salewski RP,
Christman
MC, Girard
SA,
Tompkins
TA.
Effectiveness of
Lactobacillus
helveticus and
Lactobacillus
rhamnosus for
the management
of antibiotic-
associated
diarrhoea in
healthy adults: a
Br J Nutr. 2016 116(1):94-103

3Clinical Epidemiology
randomised,
double-blind,
placebo-
controlled trial.
4 Dietrich CG,
Kottmann T,
Alavi M
Commercially
available
probiotic drinks
containing
Lactobacillus
casei DN-
114001 reduce
antibiotic-
associated
diarrhea
World J
Gastroenterol.
2014 14;20(42):15837-44
5 Chatterjee S,
Kar P, Das T,
Ray S,
Gangulyt S,
Rajendiran C,
Mitra M.
Randomised
placebo-
controlled
double blind
multicentric trial
on efficacy and
safety of
Lactobacillus
acidophilus LA-
5 and
Bifidobacterium
BB-12 for
prevention of
antibiotic-
J Assoc
Physicians
India
2013 61(10):708-12

4Clinical Epidemiology
associated
diarrhoea.
6 Wright K1,
Wright H,
Murray M.
Probiotic
treatment for the
prevention of
antibiotic-
associated
diarrhoea in
geriatric
patients: a
multicentre
randomised
controlled pilot
study.
Australas J
Ageing
2015 34(1):38-42.
7 Allen SJ1,
Wareham K,
Wang D,
Bradley C,
Sewell B,
Hutchings H,
Harris W,
Dhar A,
Brown H,
Foden A,
Gravenor
MB, Mack D,
Phillips CJ.
A high-dose
preparation of
lactobacilli and
bifidobacteria in
the prevention of
antibiotic-
associated and
Clostridium
difficile
diarrhoea in
older people
admitted to
hospital: a
multicentre,
Health Technol
Assess.
2013 17(57):1-140

5Clinical Epidemiology
randomised,
double-blind,
placebo-
controlled,
parallel arm trial
(PLACIDE).
8 Ouwehand
AC,
DongLian C,
Weijian X,
Stewart M, Ni
J, Stewart T,
Miller LE.
Probiotics
reduce
symptoms of
antibiotic use in
a hospital
setting: a
randomized dose
response study
Vaccine 2014 16;32(4):458-63
9 Wong S,
Jamous A,
O'Driscoll J,
Sekhar R,
Weldon M,
Yau CY,
Hirani SP,
Grimble G,
Forbes A.
A Lactobacillus
casei Shirota
probiotic drink
reduces
antibiotic-
associated
diarrhoea in
patients with
spinal cord
injuries: a
randomised
controlled trial
Br J Nutr. 2014 111(4):672-8
10 Allen SJ1, Lactobacilli and Lancet 2013 12;382(9900):1249-

6Clinical Epidemiology
Wareham K,
Wang D,
Bradley C,
Hutchings H,
Harris W,
Dhar A,
Brown H,
Foden A,
Gravenor
MB, Mack D.
bifidobacteria in
the prevention of
antibiotic-
associated
diarrhoea and
Clostridium
difficile
diarrhoea in
older inpatients
(PLACIDE): a
randomised,
double-blind,
placebo-
controlled,
multicentre trial.
57
11 Selinger CP,
Bell A, Cairns
A, Lockett M,
Sebastian S,
Haslam N.
Probiotic VSL#3
prevents
antibiotic-
associated
diarrhoea in a
double-blind,
randomized,
placebo-
controlled
clinical trial.
J Hosp Infect 2013 84(2):159-65
12 Allen SJ,
Wareham K,
Bradley C,
A multicentre
randomised
controlled trial
BMC Infect
Dis
2012 6;12:108.

7Clinical Epidemiology
Harris W,
Dhar A,
Brown H,
Foden A,
Cheung WY,
Gravenor
MB, Plummer
S, Phillips CJ,
Mack D.
evaluating
lactobacilli and
bifidobacteria in
the prevention of
antibiotic-
associated
diarrhoea in
older people
admitted to
hospital: the
PLACIDE study
protocol.
13 Pozzoni P,
Riva A,
Bellatorre
AG, Amigoni
M, Redaelli
E, Ronchetti
A, Stefani M,
Tironi R,
Molteni EE,
Conte D,
Casazza G,
Colli A.
Saccharomyces
boulardii for the
prevention of
antibiotic-
associated
diarrhea in adult
hospitalized
patients: a
single-center,
randomized,
double-blind,
placebo-
controlled trial.
Am J
Gastroenterol.
2012 107(6):922-31
14 Cimperman
L1, Bayless
G, Best K,
A randomized,
double-blind,
placebo-
2011 J Clin
Gastroenterol
45(9):785-9

8Clinical Epidemiology
Diligente A,
Mordarski B,
Oster M,
Smith M,
Vatakis F,
Wiese D,
Steiber A,
Katz J.
controlled pilot
study of
Lactobacillus
reuteri ATCC
55730 for the
prevention of
antibiotic-
associated
diarrhea in
hospitalized
adults.
15 Song HJ1,
Kim JY, Jung
SA, Kim SE,
Park HS,
Jeong Y,
Hong SP,
Cheon JH,
Kim WH,
Kim HJ, Ye
BD, Yang
SK, Kim SW,
Shin SJ, Kim
HS, Sung JK,
Kim EY.
Effect of
probiotic
Lactobacillus
(Lacidofil® cap)
for the
prevention of
antibiotic-
associated
diarrhea: a
prospective,
randomized,
double-blind,
multicenter
study.
J Korean Med
Sci.
2010 25(12):1784-91
16 Gao XW1,
Mubasher M,
Fang CY,
Dose-response
efficacy of a
proprietary
2010 Am J
Gastroenterol
105(7):1636-41

9Clinical Epidemiology
Reifer C,
Miller LE.
probiotic
formula of
Lactobacillus
acidophilus
CL1285 and
Lactobacillus
casei LBC80R
for antibiotic-
associated
diarrhea and
Clostridium
difficile-
associated
diarrhea
prophylaxis in
adult patients
17 Lönnermark
E1, Friman V,
Lappas G,
Sandberg T,
Berggren A,
Adlerberth I.
Intake of
Lactobacillus
plantarum
reduces certain
gastrointestinal
symptoms
during treatment
with antibiotics.
J Clin
Gastroenterol.
2010 44(2):106-12.
18 Allen SJ1,
Wareham K,
Wang D,
Bradley C,
A high-dose
preparation of
lactobacilli and
bifidobacteria in
Health Technol
Assess.
2013 17(57):1-140