Antibiotic-associated diarrhea (AAD) is the most common adverse effect of antibiotic therapy. Our aim was to determine the effectiveness of a dietary supplement of yogurt for prevention of AAD. Two hundred two hospitalized patients receiving oral or intravenous antibiotics were randomized to receive or not receive a dietary yogurt supplement, consisting of 227 grams of commercial yogurt, and followed for 8 days. Mean age of the study group was 70 years and 43% were male. Compliance and 8-day follow-up were 85% and 91%, respectively. Patients receiving yogurt reported less frequent diarrhea (12% vs 24%; P = 0.04), and significantly less total diarrheal days (23 vs 60). The cumulative proportions of patients without diarrhea were significantly different (P = 0.02) between patients receiving and not receiving yogurt. For conclusion, dietary supplementation with yogurt is a simple, effective, and safe treatment that decreases the incidence and duration of AAD.
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McFarland LV: Risk factors for antibiotic-associated diarrhea. A review of literature. Ann Med Intern 149(5):261-266, 1998
McFarland LV: Epidemiology, risk factors and treatment for antibiotic-associated diarrhea. Dig Dis 16(5):292-307, 1998
Wistrom J, Norrby SR, Myhre EB, et al: Frequency of antibiotic-associated diarrhea in 2462 antibiotic-treated hospitalized patients: a prospective study. J Antimicrob Chemother 47(1):43-50, 2001
Bartlett JG: Pseudomembranous enterocolitis and antibiotic-associated colitis. In MH Sleisinger, JS Fordtran (Eds.) Grastrointestinal Diseases; 5th ed. Philadelphia, WB Saunders, 1993, pp 1174-1185
Hogenauer C, Hammer HF, Krejs GJ, et al: Mechanism and management of antibiotic-associated diarrhea. Clin Infect Dis 27:702-710, 1998
Wilcox MH, Cunniffe JG, Trundle C, et al: Financial burden of hospital-acquired Clostridium difficile infection. J Hosp Infect 34:23-30, 1996
MacGowan AP, Brown I, Feeney R. et al: Clostridium difficile associated diarrhea and length of hospital stay. J Hosp Infect 31:241-44, 1995
Elmer GW, Surawicz CM, McFarland LV: Biotherapeutic agents—a neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 275(11):870-76, 1996
Minitab User's Guide: Release 13 for Windows. Minitab, Inc. 1999
Cytel: StatXact 4 Windows User Manuals. Cytel Software Corporation, Cambridge, Massachusetts, 1999
Gotz V, Romankiewicz JA, Moss J, et al: Prophylaxis against ampicillin-associated diarrhea with a Lactobacillus preparation. Am J Hosp Pharm 36:754-757, 1979
Anon: Bacid, Lactinex and yogurt. Med. Letter Drug Ther 14:59-60, 1972
Colombel JF, Cortot A, Neut C, et al: Yogurt with Bifidobacterium longum reduces erythromycin-induced gastrointestinal effects. Lancet 2:43, 1987
Vanderhoof JA, Whitney DB, Antonson DL, et al: Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Paediatr 135(5):564-8, 1999
Armuzzi A, Cremonin F, Bartolozzi F, et al: The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori therapy. Aliment Pharmacol Ther 15(2):163-169, 2001
Witsell DL, Garrett G, Yarbrough WG, et al: Effect of Lactobacillus acidophilus on antibiotic associated gastrointestinal morbidity. Prospective randomized trial. J Otolaryngol (24) 230-233, 1995
Lidbeck A, Edlund C, Gustafsson JA, et al: Impact of Lactobacillus acidophilus on the normal intestinal microflora after administration of two antimicrobial agents. Infection 16(6):329-36, 1988
Malin M, Suomalainen H, Saxelin M, et al: Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab 40:137-45, 1996
Madsen KL, Tavenini MM, Doyle JSG, et al: Interleukin-10 gene deficient mice demonstrate a primary defect in IgA secretion. Gastroenty 112:A1031, 1997
Kruis W, Schultz E, Fric P, et al: Double-blind comparison of an oral Escherichia coli preparation and mesalamine in maintaining remission of ulcerative colitis. Aliment Pharmacol Ther 11:853-8, 1997
Gionchetti P, Rizzello F, Matteuzzi D, et al: Microflora in IBD pathogenesis. Possible therapeutic role of probiotics. Gastroenterol Int 11:108-11, 1998
Surawicz, CM, Elmer, GW, Speelman P, et al: Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterology 96:981-8, 1989
Biller JA, Katz AJ, Flores AF: Treatment of recurrent C. difficile colitis with Lactobacillus GG. J Pediatr. Gastroenterol Nutr 21:224-226, 1995
Gorbach SL, Chang T, Goldin B: Successful treatment of relapsing Clostridium colitis with Lactobacillus GG. Lancet 2:1519, 1987
Pochapin M: The effect of probiotics on Clostridium difficle diarrhea. Am J. Gastroenterol 95(1):S11-14, 2000
Hrobjartsson A, Gotzsche PC: Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. NEJM 344(21):1594-1602, 2001
Bartlet JG: Antibiotic-associated diarrhea. NEJM 346(5):334-339, 2002
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Beniwal, R.S., Arena, V.C., Thomas, L. et al. A Randomized Trial of Yogurt for Prevention of Antibiotic-Associated Diarrhea. Dig Dis Sci 48, 2077–2082 (2003). https://doi.org/10.1023/A:1026155328638
- dietary intervention
- antibiotic-associated diarrhea