Clinical Question In adults and children prescribed antibiotics, is co-administration of a probiotic associated with a lower risk of symptomatic Clostridium difficile infection without an increase in adverse events?
Bottom Line Moderate-quality evidence suggests that probiotics are associated with a lower risk of C difficileinfection and very low–quality evidence suggests that probiotics are associated with fewer adverse events vs placebo or no treatment.
Antibiotics are commonly prescribed and are associated with Clostridium difficile infection (CDI) and its complications including toxic megacolon and death.1 Recent data suggest that treating CDI costs $24 205 per patient.2 This JAMA Clinical Evidence Synopsis summarizes a recent Cochrane review.3
Among 31 studies comparing antibiotics and probiotics vs placebo or no treatment for preventing CDI in patients receiving antibiotics, probiotics were associated with a lower risk of CDI, adverse events, and antibiotic-associated diarrhea.