Evidence does not support use of probiotic therapy alone or as an adjunct to antibiotic therapy in Clostridium difficile colitis, a Cochrane review concludes.
Researchers found there was not enough evidence to recommend probiotic therapy as an adjunct to antibiotic therapy for C difficile colitis, and no evidence to support using probiotics alone in treatming such colitis.
The investigators sought randomised, prospective studies using probiotics for treating documented C difficile colitis and identified four that met the inclusion criteria.
These studies examined the use of probiotics in conjunction with conventional antibiotics (vancomycin or metronidazole) for treating recurrence or an initial episode of C difficile colitis in adults.
The studies were small and had methodological problems.
A statistically significant benefit for probiotics combined with antibiotics was found in one study, in which patients receiving Saccharomyces boulardii were less likely than those on placebo to experience recurrence of C difficile diarrhoea (RR 0.59; 95% CI 0.35-0.98).
However, no benefit of probiotics treatment was found in the other studies.