JAC:四联益生菌显著改善腹泻而无法预防CDI复发

选取33名艰难梭菌感染(CDI)患者,研究益生菌对CDI的疗效;
干预持续28天,CDI患者分为2组,益生菌组每日口服包含4种菌株的益生菌胶囊(嗜酸乳杆菌NCFM、副干酪乳杆菌Lpc-37、乳双歧杆菌Bi-07、乳双歧杆菌Bl-04),对照组口服外观和味道相同的安慰剂;
益生菌组的腹泻症状得到显著改善:腹泻持续时间显著缩短,腹泻频率显著降低;
CDI复发在两组之间无显著差别,需要更大样本量的随机临床试验进行进一步研究。
延伸阅读

A randomized controlled trial of probiotics for Clostridium difficile infection in adults (PICO)

益生菌用于治疗成人艰难梭菌感染的随机对照试验(PICO)

2017-08-23, Article, 10.1093/jac/dkx254more

Abstract:
Background: Clostridium difficile is the most common cause of hospital-acquired infections, responsible for >450 000 infections annually in the USA. Probiotics provide a promising, well-tolerated adjunct therapy to standard C. difficile infection (CDI) treatment regimens, but there is a paucity of data regarding their effectiveness for the treatment of an initial CDI.
Objectives: We conducted a pilot randomized controlled trial of 33 participants from February 2013 to February 2015 to determine the feasibility and health outcomes of adjunct probiotic use in patients with an initial mild to moderate CDI.
Methods: The intervention was a 28 day, once-daily course of a four-strain oral probiotic capsule containing Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, Bifidobacterium lactis Bi-07 and B. lactis Bl-04. The control placebo was identical in taste and appearance. Registered at clinicaltrials.gov: trial registration number = NCT01680874.
Results: Probiotic adjunct therapy was associated with a significant improvement in diarrhoea outcomes. The primary duration of diarrhoea outcome (0.0 versus 1.0 days; P = 0.039) and two exploratory outcomes, total diarrhoea days (3.5 versus 12.0 days; P = 0.005) and rate of diarrhoea (0.1 versus 0.3 days of diarrhoea/stool diary days submitted; P = 0.009), all decreased in participants with probiotic use compared with placebo. There was no significant difference in the rate of CDI recurrence or functional improvement over time between treatment groups.
Conclusions: Probiotics are a promising adjunct therapy for treatment of an initial CDI and should be further explored in a larger randomized controlled trial.

First Authors:
Anna K Barker

Correspondence Authors:
Nasia Safdar

All Authors:
Anna K Barker,Megan Duster,Susan Valentine,Timothy Hess,Laurie Archbald-Pannone,Richard Guerrant,Nasia Safdar