Prophylactic use of Saccharomyces boulardii probiotics in preventing antibiotic-associated diarrhea: A single center hospital-based case-control study in Serbia

Nikola Panic, Maja Tufegdzic, Stefania Boccia, Marija Stokic, Milutin Bulajic

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Antibiotic-associated diarrhea (AAD) develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii) prevents occurrence of AAD among adult hospitalized patients. METHODS: Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S. boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs) and their 95% confidence interval (CI) derived from logistic regression analysis. RESULTS: Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05), and almost half (49.15%) were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85%), followed by fluoroquinolones (28.81%) and trimethoprim-sulfamethoxazole (20.34%). Significantly more cases than controls were treated with carbapenems (16.95% vs. 5.08% respectively, p=0.04). Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64% vs. 42.37% p=0.005). We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95% CI: 0.14-0.72) and multivariate analysis (OR:0.36, 95% CI: 0.14-0.80). Use of carbapenems was borderline significant risk factor for development of AAD in univariate (OR: 3.81, 95% CI: 0.99-14.64) as well as multivariate analysis (OR: 3.82, 0.91-16.08) (Table 3). CONCLUSION: Prophylactic use of probiotics containing Saccharomyces boulardii acts protectively against antibiotic-associated diarrhea among hospitalized patients.

Original languageEnglish
Article numbere11607
JournalEpidemiology Biostatistics and Public Health
Volume12
Issue number4
DOIs
Publication statusPublished - 2015

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Serbia
Probiotics
Case-Control Studies
Diarrhea
Anti-Bacterial Agents
Odds Ratio
Confidence Intervals
Carbapenems
Saccharomyces boulardii
Multivariate Analysis
Hospital Records
Fluoroquinolones
Sulfamethoxazole Drug Combination Trimethoprim
Cephalosporins
Geriatrics

Keywords

  • Antibiotic-associated diarrhea
  • Clostridium difficile infection
  • Probiotics
  • Prophylaxis
  • Saccharomyces boulardii

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Community and Home Care

Cite this

Prophylactic use of Saccharomyces boulardii probiotics in preventing antibiotic-associated diarrhea : A single center hospital-based case-control study in Serbia. / Panic, Nikola; Tufegdzic, Maja; Boccia, Stefania; Stokic, Marija; Bulajic, Milutin.

In: Epidemiology Biostatistics and Public Health, Vol. 12, No. 4, e11607, 2015.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Antibiotic-associated diarrhea (AAD) develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii) prevents occurrence of AAD among adult hospitalized patients. METHODS: Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S. boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs) and their 95{\%} confidence interval (CI) derived from logistic regression analysis. RESULTS: Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05), and almost half (49.15{\%}) were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85{\%}), followed by fluoroquinolones (28.81{\%}) and trimethoprim-sulfamethoxazole (20.34{\%}). Significantly more cases than controls were treated with carbapenems (16.95{\%} vs. 5.08{\%} respectively, p=0.04). Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64{\%} vs. 42.37{\%} p=0.005). We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95{\%} CI: 0.14-0.72) and multivariate analysis (OR:0.36, 95{\%} CI: 0.14-0.80). Use of carbapenems was borderline significant risk factor for development of AAD in univariate (OR: 3.81, 95{\%} CI: 0.99-14.64) as well as multivariate analysis (OR: 3.82, 0.91-16.08) (Table 3). CONCLUSION: Prophylactic use of probiotics containing Saccharomyces boulardii acts protectively against antibiotic-associated diarrhea among hospitalized patients.",
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AU - Panic, Nikola

AU - Tufegdzic, Maja

AU - Boccia, Stefania

AU - Stokic, Marija

AU - Bulajic, Milutin

PY - 2015

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N2 - BACKGROUND: Antibiotic-associated diarrhea (AAD) develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii) prevents occurrence of AAD among adult hospitalized patients. METHODS: Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S. boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs) and their 95% confidence interval (CI) derived from logistic regression analysis. RESULTS: Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05), and almost half (49.15%) were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85%), followed by fluoroquinolones (28.81%) and trimethoprim-sulfamethoxazole (20.34%). Significantly more cases than controls were treated with carbapenems (16.95% vs. 5.08% respectively, p=0.04). Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64% vs. 42.37% p=0.005). We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95% CI: 0.14-0.72) and multivariate analysis (OR:0.36, 95% CI: 0.14-0.80). Use of carbapenems was borderline significant risk factor for development of AAD in univariate (OR: 3.81, 95% CI: 0.99-14.64) as well as multivariate analysis (OR: 3.82, 0.91-16.08) (Table 3). CONCLUSION: Prophylactic use of probiotics containing Saccharomyces boulardii acts protectively against antibiotic-associated diarrhea among hospitalized patients.

AB - BACKGROUND: Antibiotic-associated diarrhea (AAD) develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii) prevents occurrence of AAD among adult hospitalized patients. METHODS: Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S. boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs) and their 95% confidence interval (CI) derived from logistic regression analysis. RESULTS: Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05), and almost half (49.15%) were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85%), followed by fluoroquinolones (28.81%) and trimethoprim-sulfamethoxazole (20.34%). Significantly more cases than controls were treated with carbapenems (16.95% vs. 5.08% respectively, p=0.04). Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64% vs. 42.37% p=0.005). We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95% CI: 0.14-0.72) and multivariate analysis (OR:0.36, 95% CI: 0.14-0.80). Use of carbapenems was borderline significant risk factor for development of AAD in univariate (OR: 3.81, 95% CI: 0.99-14.64) as well as multivariate analysis (OR: 3.82, 0.91-16.08) (Table 3). CONCLUSION: Prophylactic use of probiotics containing Saccharomyces boulardii acts protectively against antibiotic-associated diarrhea among hospitalized patients.

KW - Antibiotic-associated diarrhea

KW - Clostridium difficile infection

KW - Probiotics

KW - Prophylaxis

KW - Saccharomyces boulardii

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