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

نویسندگان

  • 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
  • Bernhard Ruf
  • Rainer Porschen
  • Guido Trenn
  • Trude Butterfaß-Bahloul
  • Gudrun Wuerthwein
  • Frank Oeder
  • Andreas Runge
  • Esther Klauss
  • Nina Hansen-Rosenblatt
  • Tobias Werner
  • Kornelius Schulze
  • Benno Kreuels
  • Guido Schäfer
  • Peter Hübener
  • Annette Hennigs
  • Claudia Beisel
  • Dorothee Fischer-Brügge
  • Katharina Zimmermann-Fraedrich
  • Claudia Röder
  • Nadine Grigo
  • Armin Riecke
  • Helmut Schreckenbauer
  • Christoph Hemmer
  • Sebastian Klammt
  • Hilte Geerdes-Fenge
  • Silvius Frimmel
  • Jens M. Kittner
  • Johannes W. Rey
  • Joern M. Schattenberg
  • Florian Thieringer
  • Rudolf Schmits
  • Daniel Grandt
  • Philipp Martin Büch
  • Alexander Klebert
  • Marc Andreas Mittag
  • Sybille Lehnen
  • Daniel Tiefengraber
  • Klaus Radecke
  • Iris Hering
  • Wolfgang Zeller
  • Lisa Rundt
  • Lars Brandt
  • Peter Baltes
  • Dani Dajani
  • Niehls Kurniawan
  • Carola Pflüger
  • Nassim Behjat
  • Ulrike Engel
  • Martina Unger
چکیده

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.

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عنوان ژورنال:

دوره 3  شماره 

صفحات  -

تاریخ انتشار 2016