TY - JOUR
T1 - Saccharomyces boulardii to prevent antibiotic-associated diarrhea
T2 - A randomized, double-masked, placebo-controlled trial
AU - for the SacBo Study Groupa
AU - Ehrhardt, Stephan
AU - Guo, Nan
AU - Hinz, Rebecca
AU - Schoppen, Stefanie
AU - May, Jürgen
AU - Reiser, Markus
AU - Schroeder, Maximilian Philipp
AU - Schmiedel, Stefan
AU - Keuchel, Martin
AU - Reisinger, Emil C.
AU - Langeheinecke, Andreas
AU - de Weerth, Andreas
AU - Schuchmann, Marcus
AU - Schaberg, Tom
AU - Ligges, Sandra
AU - Eveslage, Maria
AU - Hagen, Ralf M.
AU - Burchard, Gerd D.
AU - Lohse, Ansgar W.
AU - Ruf, Bernhard H.
AU - Porschen, Rainer
AU - Trenn, Guido
AU - Butterfaß-Bahloul, Trude
AU - Wuerthwein, Gudrun
AU - Urban, Marc
AU - Oeder, Frank
AU - Runge, Andreas
AU - Klauss, Esther
AU - Hansen-Rosenblatt, Nina
AU - Werner, Tobias
AU - Schulze, Kornelius
AU - Kreuels, Benno
AU - Schäfer, Guido
AU - Hübener, Peter
AU - Hennigs, Annette
AU - Beisel, Claudia
AU - Fischer-Brügge, Dorothee
AU - Zimmermann-Fraedrich, Katharina
AU - Röder, Claudia
AU - Grigo, Nadine
AU - Riecke, Armin
AU - Schreckenbauer, Helmut
AU - Hemmer, Christoph
AU - Klammt, Sebastian
AU - Geerdes-Fenge, Hilte
AU - Frimmel, Silvius
AU - Kittner, Jens M.
AU - Rey, Johannes W.
AU - Schattenberg, Joern M.
AU - Thieringer, Florian
N1 - Publisher Copyright:
© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - Antibiotic-associated diarrhea
KW - Clostridium difficile-associated diarrhea
KW - Probiotic
KW - Randomized controlled trial
KW - Saccharomyces boulardii
UR - http://www.scopus.com/inward/record.url?scp=85000580131&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85000580131&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofw011
DO - 10.1093/ofid/ofw011
M3 - Article
C2 - 26973849
AN - SCOPUS:85000580131
SN - 2328-8957
VL - 3
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 1
ER -