Clostridium difficile, also known more commonly as C. diff, accounts for 10 to 20% of antibiotic-associated diarrhea cases, because the antibiotics administered for the treatment of certain disease processes such as
inflammatory colitis also inadvertently kill a large portion of the
gut flora, the
normal flora that is usually present within the
bowel. With this lower level of "healthy" bacteria present, the overgrowth of C. diff is then responsible "for elaborating the
enterotoxin".[1]
Treatment
Meta-analyses have concluded that
probiotics may protect against antibiotic-associated diarrhea in both children and adults.[2][3] Evidence is insufficient, however, regarding an effect on rates of
C. difficile colitis.[4]
Efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage.[5][6] Up to a 50% reduction of AAD occurrences has been found.[7] No
side effects have been reported. Caution is advised when using probiotics in
immunocompromised individuals or those who have a compromised
intestinal barrier because of the risk of an infection caused by the probiotic supplements.[citation needed]
References
^
abAllan B. Wolfson, ed. (2005). Harwood-Nuss' Clinical Practice of Emergency Medicine (4th ed.). p. 400.
ISBN0-7817-5125-X.
^Hempel, S; Newberry, SJ; Maher, AR; Wang, Z; Miles, JN; Shanman, R; Johnsen, B; Shekelle, PG (May 9, 2012). "Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis". JAMA: The Journal of the American Medical Association. 307 (18): 1959–69.
doi:
10.1001/jama.2012.3507.
PMID22570464.
^Surawicz, C. M. (2008). "Role of Probiotics in Antibiotic-associated Diarrhea, Clostridium difficile-associated Diarrhea, and Recurrent Clostridium difficile-associated Diarrhea". Journal of Clinical Gastroenterology. 42: S64–S70.
doi:
10.1097/MCG.0b013e3181646d09.
PMID18545161.
S2CID37993276.
^Sazawal, S; Hiremath, G; Dhingra, U; Malik, P; Deb, S; Black, RE (June 2006). "Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials". The Lancet Infectious Diseases. 6 (6): 374–82.
doi:
10.1016/S1473-3099(06)70495-9.
PMID16728323.