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Probiotic drinks can help reduce diarrhoea associated with antibiotics

BMJ

Drinks containing probiotic bacteria can help reduce diarrhoea among older people, which may reduce length of stay in hospital and save the NHS money, say Imperial College researchers at Hammersmith Hospital in a study published on bmj.com today.

Between 5% and 25% of patients experience diarrhoea, including Clostridium difficile associated diarrhoea, as a complication of treatment with antibiotics.

Researchers set out to find whether probiotic drinks, which contain live micro-organisms, are helpful in reducing diarrhoea related to antibiotic use.

They identified 135 people from three London hospitals who were all aged over 50 and receiving antibiotics for various reasons, such as for respiratory infection.

The patients were split at random into two groups. One was given a commercially available probiotic yoghurt drink while the other received a longlife, sterile milkshake. Neither group knew which drink they received.

Drinks were given twice a day, within 48 hours of the people starting antibiotic therapy and continued for one week after the antibiotics were stopped. The people were also contacted for follow up four weeks later.

Nursing staff monitored bowel movements and when there was evidence of diarrhoea, samples were taken for analysis.

Of the 113 patients who were able to be contacted for follow-up, results showed the group taking probiotic drinks fared much better. Only 12% of those people developed antibiotic-associated diarrhoea, compared to 34% of the other group.

Of the probiotic group of patients, none developed C.difficile associated diarrhoea, compared to 17% of people in the other group.

Apart from the health benefits, the researchers say that considerable savings may be made from greater use of probiotic drinks.

The researchers estimate cost of supplying the probiotic drink to prevent one case of C.difficile associated diarrhoea to be £60. Previous published research suggests that treating one case of C.difficile can cost on average £4,000 because of increased length of stay and use of drugs.

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