Use of Probiotics to Treat C. Difficile Increasing in Inpatients
October 11th, 2016
ATLANTA – The jury is still out on whether probiotics effectively preserve or restore a healthy microbiome.
A trend toward increasing use of probiotics among hospitalized patients, however, suggests that many clinicians believe the agents might be helpful in treating Clostridium difficile infection (CDI), according to new research.
A descriptive study of 145 U.S. hospitals, published recently in the American Journal of Infection Control, finds that more patients are receiving probiotics as part of their inpatient hospital care. That is especially the case when hospitalized patients are diagnosed with CDI, which often is associated with a disrupted or damaged microbiome, according to researchers from the national Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion.
The study found that, in 2012, probiotics – most often Saccharomyces and Lactobacillus -- were used in 2.6% of hospitalizations and 96% of the healthcare centers in the sample, representing 51,724 hospitalizations.
Results also indicate that patients receiving probiotics were nine times more likely to receive antimicrobials and 21 times more likely to have a Clostridium difficile infection diagnosis. The article reports that 32% of patients treated with probiotics received Saccharomyces boulardii, 30% received Lactobacillus acidophilus and Lactobacillus bulgaricus, 28% received L acidophilus and 11% received Lactobacillus rhamnosus.
Overall, probiotic use increased from 1.0% of 1,090,373 discharges in 2006 to 2.9% of 1,006,051 discharges in 2012, according to the report.
“In this sample of U.S. hospitals, a sizable and growing number of inpatients received probiotics as part of their care despite inadequate evidence to support their use in this population,” study authors conclude. “Additional research is needed to guide probiotic use in the hospital setting.”
For clinicians intent on using the products, the CDC researchers urge being wary of product-labeling inaccuracies at the species, and even genus level, for reasons such as difficulty in identification, desire for consumer recognition and cross-contamination during manufacturing as well as varying susceptibility of strains to antibiotics, and product viability at the time of ingestion.
“The general questions needing to be answered include the following: Which strain-specific organisms, which patient populations, at what doses, and in what time frames (related to antibiotic use in particular) are both safe and effective in the prevention or treatment of which diseases?” they add.