Use of Probiotics for Primary and Secondary Prophylaxis for Reducing rate of C. difficile as Standardized Health-Care Practice

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According to the article The mechanism and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea there is a great concern about increasing incidence of C. difficile infection due to use of broad spectrum antibiotics. Clindamycin, third generation of cephalosporins and flouroquinolones are considered high risk antibiotics. It is believed that normal gastrointestinal flora has potential effect in inhibition C.difficile growth and toxin A,B release which offen associated with sever diarrhea resulting in patient’s mortality and other comorbidities. After first episode, there is a high chance for relapses due to reduction serum IgG antibodies to toxin A and colonic IgA secretion cells. Metronidazole and …show more content…
However, it still remains to be insufficient to conclude its benefit. In this study, had low risks for recurrence rate, the study was conducted at community setting, and excluded immunocompromised population. According to Conchrane review that had conducted its search through MEDLINE, EMBASE, The Conchrane IBD/FBD Specialized trials from 1966 to 2007, its conclusion was based on randomized control trials examining efficacy of probiotics. Those trials had many limitations, such as: lack of power to detect statistical significance, existence of considerable clinical heterogenecity related to antibiotic use and disease state and conflicting results among compared to other studies. There are some trials done on primary prophylaxis in reducing rate of C.difficile, but these results can not apply to practice due to narrowed eligibility criteria, small size trials and most results were not obtained from human vivo studies. In conclusion, based above information provided, I would not recommend the use of probiotics for primary and secondary prophylaxis for reducing rate of C. difficile as standardized health-care practice. It requires futher evaluation on its effectiveness due to lack of sufficient evidence. The available evidence is inconsistent in results and more focused on reducing incidence of simple-moderate C. difficile associated diarrhea. Monotherapy with probiotics should be avoided in patients

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