Florastor Case Study

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Thank you for you information request on Florastor® (Saccharomyces boulardii) and prevention of Clostridium difficile. As you stated earlier, Ms. JS was recently transferred from another facility to Llano Estacado Estates for a higher level of care. JS is an 84 year old, female patient that has been diagnosed with Alzheimer’s dementia, anxiety, depression, insomnia, hypothyroidism, constipation, and gastro-esophageal reflux disease (GERD). She is currently on the following medications: Aricept® (donepezil) 10 mg PO daily, levothyroxine 50 mcg PO daily, Protonix® (pantoprazole) 40 mg PO daily, Cymbalta® (duloxetine) 60 mg PO daily, trazodone 50 mg PO HS prn, Tylenol® (acetaminophen) 650 mg PO prn pain, Miralax® (polyethylene glycol) 17 g PO …show more content…
difficile has been steadily increasing in occurrence and severity since its discovery in 1970.1 C. difficile is a Gram-positive, spore-forming, toxin-producing, anaerobic bacteria that is responsible for gastrointestinal colitis. It is now considered the most common infectious cause of antibiotic and health care associated diarrhea. According to the Centers for disease control it was accountable for nearly half a million cases and around 29,000 deaths in the United States during 2011 alone. Cases responsible for hospitalizations have doubled from 2000 to 2010 and are projected to increase in the future.2 Cases of C. difficile have also been increasing in community and nursing home settings as well. Prevention of C. difficile infections has been an increasing area of study as it represents a growing burden to the health care community. Since C. difficile infection has been linked to antibiotic therapy, the use of probiotics to restore normal commensal flora has been researched as method of prevention. Florastor®, which contains the yeast Saccharomyces boulardii, is a commonly used and widely available probiotic to help restore normal flora in humans. There have been quite a few studies, reviews, and trials, a few of which I have included, conducted to address its …show more content…
boulardii would prevent antibiotic-associated diarrhea (AAD) or C. difficile-associated diarrhea (CDAD). A total of 275 patients, whose average age was 79.2 years old, were enrolled in the study which 134 receiving a placebo and 141 receiving S. boulardii and were monitored for diarrhea. Diarrhea, according to the study, meant having the passage of three or more liquid stools over days or at least five passages in a 48 hour period. Patients were monitored for the duration of the antibiotic treatment and for 12 weeks after discontinuation, with diarrhea during this timeframe being considered ADD and if it tested positive for C. difficile toxins, then it was considered CDAD. There were 71 patients who were unable to complete the study because of death during or after, transfer to another hospital, or discontinuation of the antibiotic treatment. This left 204 patients, whose average age was now 78.4 years old, who completed the study and were analyzed for occurrence of diarrhea. Of those 204, 98 received the placebo and 106 received S. boulardii capsules. There was no statistical difference in the occurrence of ADD (P=0.71) since 13 in the placebo group (13.3%) and 16 in the S.

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