TY - JOUR
T1 - Use of prophylactic Saccharomyces boulardii to prevent Clostridium difficile infection in hospitalized patients
T2 - a controlled prospective intervention study
AU - Carstensen, Jeppe West
AU - Chehri, Mahtab
AU - Schønning, Kristian
AU - Rasmussen, Steen Christian
AU - Anhøj, Jacob
AU - Godtfredsen, Nina Skavlan
AU - Andersen, Christian Østergaard
AU - Petersen, Andreas Munk
PY - 2018
Y1 - 2018
N2 - Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 109, Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls. All occurrences of CDI in patients receiving antibiotics were reported and compared to a baseline period defined as 2 years prior to intervention. Results were analyzed using run chart tests for non-random variation in CDI rates. In addition, odds ratios for CDI were calculated. S. boulardii compliance reached 44% at the intervention hospital, and 1389 patients were treated with Sacchaflor. Monthly CDI rates dropped from a median of 3.6% in the baseline period to 1.5% in the intervention period. S. boulardii treatment was associated with a reduced risk of CDI at the intervention hospital: OR = 0.06 (95% CI 0.02-0.16). At two control hospitals, CDI rates did not change. At one control hospital, the median CDI rate dropped from 3.5 to 2.4%, possibly reflecting the effects of simultaneous multifaceted intervention against CDI at that hospital. The results from this controlled prospective interventional study indicate that S. boulardii is effective for the prevention of CDI in an unselected cohort of mainly elderly patients from departments of internal medicine.
AB - Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 109, Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls. All occurrences of CDI in patients receiving antibiotics were reported and compared to a baseline period defined as 2 years prior to intervention. Results were analyzed using run chart tests for non-random variation in CDI rates. In addition, odds ratios for CDI were calculated. S. boulardii compliance reached 44% at the intervention hospital, and 1389 patients were treated with Sacchaflor. Monthly CDI rates dropped from a median of 3.6% in the baseline period to 1.5% in the intervention period. S. boulardii treatment was associated with a reduced risk of CDI at the intervention hospital: OR = 0.06 (95% CI 0.02-0.16). At two control hospitals, CDI rates did not change. At one control hospital, the median CDI rate dropped from 3.5 to 2.4%, possibly reflecting the effects of simultaneous multifaceted intervention against CDI at that hospital. The results from this controlled prospective interventional study indicate that S. boulardii is effective for the prevention of CDI in an unselected cohort of mainly elderly patients from departments of internal medicine.
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents/adverse effects
KW - Antibiosis
KW - Clostridium Infections/epidemiology
KW - Cross Infection/etiology
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Pre-Exposure Prophylaxis
KW - Probiotics/administration & dosage
KW - Saccharomyces boulardii/physiology
KW - Treatment Outcome
U2 - 10.1007/s10096-018-3267-x
DO - 10.1007/s10096-018-3267-x
M3 - Journal article
C2 - 29725956
SN - 0934-9723
VL - 37
SP - 1431
EP - 1439
JO - European Journal of Clinical Microbiology & Infectious Diseases
JF - European Journal of Clinical Microbiology & Infectious Diseases
IS - 8
ER -