The Good, the Bad, and the 'Difficile'

Diarrhea risk from Clostridium difficile bacteria decreases with probiotic usage

(RxWiki News) There is such a thing as good bacteria. And they can be helpful when upset stomachs call for constant bathroom trips.

Probiotics, or "good" bacteria, safely reduced the chances of having diarrhea caused by a certain "bad" bacteria by more than 60 percent in kids and adults, a recently published study found.

These findings show that probiotics may help balance the natural bacteria found in the gut and prevent diarrhea caused by Clostridium difficile (C. difficile).

"Ask a nutritionist about yogurt products with probiotics."

The study, led by Joshua Goldenberg, from Bastyr University in Kenmore, Washington, measured how safely and effectively probiotics worked to prevent diarrhea caused by C. difficile, a bacteria that commonly causes diarrhea, in adults and children.

Probiotics are good bacteria found in yogurt that can aid in the digestion process and protect against harmful bacteria.

The researchers reviewed 23 previously published studies, involving 4,213 participants, on C. difficile and probiotics. The studies were published between 1966 and 2013 and compared treatments involving probiotics, placebos (fake probiotics) or no treatment at all.

Included studies covered all strains of probiotics given with no limit on the dosage size. The researchers contacted the authors of studies that provided only the abstract to gather more information on those studies.

The researchers tracked the number of diarrhea cases caused by C. difficile. They also noted the number of infections caused by C. difficile, diarrhea linked with antibiotic usage and how long patients were hospitalized.

Thirteen of the studies included information on infections caused by C. difficile.

Probiotics significantly reduced the chance of having diarrhea caused by C. difficile by 64 percent, the researchers found.

Among patients who took probiotics, two percent had diarrhea, compared to 5.5 percent of patients who were given a placebo or no treatment at all.

Taking probiotics reduced the chance of having some adverse effect caused by C. difficile by 20 percent. Adverse effects include soft stools, flatulence, nausea, cramping, fever and taste disturbance.

Probiotics did not significantly reduce the number of infections caused by C. difficile. In the probiotics group, 12.6 percent of patients developed an infection, compared to 12.7 percent of patients given placebos or no treatment.

"Although probiotics are clearly superior to placebo or no treatment for preventing [C. difficile-associated diarrhea], further head-to-head trials are warranted to distinguish optimal strains and dosages," the researchers wrote in their report. "These trials should be vigilant regarding minimizing losses to follow-up and other forms of missing participant data."

Future research should focus on specific strains of C. difficile, class of antibiotics, dose size of the probiotics and the length of the treatment, the researchers wrote.

The authors noted that 16 of the 23 studies were missing between 5 and 45 percent of their data.

The study was published online May 30 in The Cochrane Collaboration. No conflicts of interest were declared.

The research was funded by the Canadian Institutes of Health Research (CIHR) Knowledge Translation Branch and the CIHR Institutes of Nutrition, Metabolism and Diabetes (INMD); and Infection and Immunity (III); the Ontario Ministry of Health and Long Term Care; and the Center for Student Research at Bastyr University.

Review Date: 
May 30, 2013