Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 S. Boulardii BID while on antibiotics and a bacteria based probiotic afterwards. Go to www.vitasearch.com and put " difficile " as your search term and you'll find quite a few research abstracts. Here's one: A Randomized Placebo-Controlled Trial of Saccharomyces boulardii in Combination With Standard Antibiotics for Clostridium difficile Disease, " McFarland LV, Surawicz CM, Greenberg RN, et al, JAMA, June 22/29, 1994;271(24):1913-1918. In evaluating 124 adults, including 64 who had their first episode of Clostridium difficile-associated disease and 60 who had a history of at least 1 prior episode of Clostridium difficile-associated disease, subjects received either Saccharomyces boulardii at a dose of 1 g/day for 4 weeks, taken as two 250-mg capsules twice a day (providing 3 x 1010 colony-forming units per day) or placebo in combination with a standard antibiotic. Results showed that a history of Clostridium difficile-associated disease significantly increased the likelihood of recurrence. Those treated with Saccharomyces boulardii and standard antibiotics had a significantly lower risk of Clostridium difficile-associated disease recurrence (relative risk of 0.43) compared with placebo and standard antibiotics. The rate of recurrence was 34.6% in the Saccharomyces boulardii group versus 64.7% in the placebo group for patients that had recurrent Clostridium difficile-associated disease. In those with an initial infection of Clostridium difficile-associated disease, the recurrence rate in the Saccharomyces boulardii group was 19.3% compared with 24.2% in the placebo group. There was no significant adverse reaction to Saccharomyces boulardii. This from pubmed: S. boulardii shows promise for the prevention of C. difficile disease recurrences http://www.ncbi.nlm.nih.gov/pubmed/20458757 Here is a nice schematic from that research article showing the benefits of S. Boulardii, including increasing SIgA levels: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/figure/F2/ >________________________________ > >To: " RD-USA (rd-usa ) " <rd-usa > >Sent: Monday, November 28, 2011 9:06 AM >Subject: C. Difficile > >Does anyone have a specific probiotic recommendation for C. Difficile? > >Thank you > > > Mazarin, MS, RD, CNS > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 Diff Stat powder Pak 2gm x 30 d is a popular order here. Sacharomyces Boulardii and bacillus Cogulan w FOS. It doesn't have to be dosed 2 hours apart from ATB as Florastor does. Osowski MS, RD, LD Registered Dietitian Sent from my iPhone > Does anyone have a specific probiotic recommendation for C. Difficile? > > Thank you > > Mazarin, MS, RD, CNS > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. Thanks! >________________________________ > >To: " rd-usa " <rd-usa > >Cc: " RD-USA (rd-usa ) " <rd-usa > >Sent: Monday, November 28, 2011 1:50 PM >Subject: Re: C. Difficile > >Diff Stat powder Pak 2gm x 30 d is a popular order here. >Sacharomyces Boulardii and bacillus Cogulan w FOS. >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. > > Osowski MS, RD, LD >Registered Dietitian >Sent from my iPhone > > > >> Does anyone have a specific probiotic recommendation for C. Difficile? >> >> Thank you >> >> Mazarin, MS, RD, CNS >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 A systematic review from the Cochrane Library: Pillal A, R. Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database of Systematic Reviews. 2008;23:CD004611. AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend probiotic therapy as an adjunct to antibiotic therapy for C. difficile colitis. There is no evidence to support the use of probiotics alone in the treatment of C. difficile colitis. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney@... http://www.linkedin.com/in/pamcharney > Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. > > Thanks! > > > > >________________________________ > > > >To: " rd-usa " <rd-usa > > >Cc: " RD-USA (rd-usa ) " <rd-usa > > >Sent: Monday, November 28, 2011 1:50 PM > >Subject: Re: C. Difficile > > > >Diff Stat powder Pak 2gm x 30 d is a popular order here. > >Sacharomyces Boulardii and bacillus Cogulan w FOS. > >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. > > > > Osowski MS, RD, LD > >Registered Dietitian > >Sent from my iPhone > > > > > > > >> Does anyone have a specific probiotic recommendation for C. Difficile? > >> > >> Thank you > >> > >> Mazarin, MS, RD, CNS > >> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 Good question , and I'm not sure. I have not read the Florastor medication insert, perhaps there is official dosing info to confirm or refute the need to dose separately from ATB? I think another consideration is that Florastor is often dosed BID while the Diff Stat is 1qd. At the facilities I work I routinely see Florastor, Diff stat and/or yogurt (with live cultures) in conjunction w ATB orders. Osowski MS, RD, LD Registered Dietitian Sent from my iPhone > Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. > > Thanks! > > > > >________________________________ > > > >To: " rd-usa " <rd-usa > > >Cc: " RD-USA (rd-usa ) " <rd-usa > > >Sent: Monday, November 28, 2011 1:50 PM > >Subject: Re: C. Difficile > > > >Diff Stat powder Pak 2gm x 30 d is a popular order here. > >Sacharomyces Boulardii and bacillus Cogulan w FOS. > >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. > > > > Osowski MS, RD, LD > >Registered Dietitian > >Sent from my iPhone > > > > > > > >> Does anyone have a specific probiotic recommendation for C. Difficile? > >> > >> Thank you > >> > >> Mazarin, MS, RD, CNS > >> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 Thanks . I didn't see anything on their website about taking it separately from antibiotics. Maybe someone else knows and can comment. I wonder if the person at your facility that originally set the groundrules for Florastor dosing didn't realize that it was a yeast based probiotic, and no one has ever questioned it? >________________________________ > >To: " rd-usa " <rd-usa > >Sent: Monday, November 28, 2011 5:44 PM >Subject: Re: C. Difficile > >Good question , and I'm not sure. I have not read the Florastor medication insert, perhaps there is official dosing info to confirm or refute the need to dose separately from ATB? >I think another consideration is that Florastor is often dosed BID while the Diff Stat is 1qd. >At the facilities I work I routinely see Florastor, Diff stat and/or yogurt (with live cultures) in conjunction w ATB orders. > > Osowski MS, RD, LD >Registered Dietitian >Sent from my iPhone > > > >> Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. >> >> Thanks! >> >> >> >> >________________________________ >> > >> >To: " rd-usa " <rd-usa > >> >Cc: " RD-USA (rd-usa ) " <rd-usa > >> >Sent: Monday, November 28, 2011 1:50 PM >> >Subject: Re: C. Difficile >> > >> >Diff Stat powder Pak 2gm x 30 d is a popular order here. >> >Sacharomyces Boulardii and bacillus Cogulan w FOS. >> >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. >> > >> > Osowski MS, RD, LD >> >Registered Dietitian >> >Sent from my iPhone >> > >> > >> > >> >> Does anyone have a specific probiotic recommendation for C. Difficile? >> >> >> >> Thank you >> >> >> >> Mazarin, MS, RD, CNS >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 I wonder how they came to that conclusion when I find many research articles to the contrary? This study is the first demonstration that the S. boulardii protease inhibits the action of both C. difficile toxins in human colon and that it may be relevant to the mechanism by which this nonpathogenic yeast exerts its beneficial effects in human C. difficile colitis. To our knowledge this is a unique mechanism of action for a biotherapeutic agent. http://iai.asm.org/content/67/1/302.full " Prevention of Antibiotic-Associated Diarrhea by Saccharomyces boulardii: A Prospective Study, " Surawicz CM, Elmer GW, Speelman P, et al, Gastroenterology, April 1989;96(4):981-988. In a prospective, double-blind, controlled study investigating antibiotic-associated diarrhea in hospitalized patients, over a 23-month period in 180 subjects who completed the study, it was found that 22% of the placebo subjects experienced diarrhea compared with 9.5% of those who received antibiotics plus lyophilized Saccharomyces boulardii concurrently at a dose of 1 g daily (two 250 mg capsules, b.i.d.). Of the Clostridium difficile-positive patients, 31% receiving placebo developed diarrhea compared with 9.4% who were taking S. boulardii. There were no adverse effects with the yeast administration. " The Use of Probiotics in Gastrointestinal Disease, " Madsen KL, Can J Gastroenterol, December 2001;15(12):817-822. Lactobacillus GG alone, or in combination with Bifidobacterium bifidum and Streptococcus thermophilus, has been shown to be effective in the treatment of Clostridium difficile. Prevention of antibiotic-induced diarrhea has occurred with the concomitant supplementation of Lactobacillus GG or Saccharomyces boulardii. Lactobacillus GG at a dose of 1x1010 viable microorganisms per day and the yeast Saccharomyces boulardii at a dose of 1 g/day have frequently been shown to be successful in studies " Saccharomyces boulardii Protease Inhibits the Effects of Clostridium difficile Toxins A and B in Human Colonic Mucosa. " Castagliuolo I, Riegler MF, Valenick L, et al, Infect Immun, January 1999;67(1):302-307. Anti-protease immunoglobulin G (IgG) prevents the action of Saccharomyces boulardii on toxin A-induced intestinal secretion and mucosal permeability to [3H] mannitol in rat ileal loops and also prevents the effects of S. boulardii protease on digestion of toxins A and B and on binding of [3H] toxin A and [3H] toxin B to purified human colonic brush border membrane. Purified S. boulardii protease reversed toxin A-and toxin B-induced inhibition of protein synthesis in human colonic (HT-29) cells. Toxin A-and B-induced drops in transepithelial resistance in human colonic mucosa occurring in Ussing chambers were reversed by 60% and 68%, respectively, by preexposing the toxins to S. boulardii protease. The effect of S. boulardii on Clostridium difficile-induced inflammatory diarrhea in humans may be due, in part, to proteolytic digestion of toxin A and B molecules by a secreted protease. " Probiotics, Antibiotic-Associated Diarrhoea and Clostridium difficile Diarrhoea in Humans, " Surawicz CM, Best Pract Res Clin Gastroenterol, 2003;17(5):775-783. Diarrhea from antibiotics can occur in up to 29% of patients who are hospitalized, although this happens at a lesser percentage in outpatients. Lactobacillus rhamnosus GG and Saccharomyces boulardii are probiotics which have been shown to reduce antibiotic-associated diarrhea. Probiotic therapy in the treatment of recurrent Clostridium difficile-associated diarrhea shows fair results utilizing Lactobacillus GG and very good results using Saccharomyces boulardii. An early uncontrolled unblinded or open trial of Saccharomyces boulardii at 500 mg, twice daily, showed benefit in recurrent Clostridium difficile-associated diarrhea in adults, as did another open trial of Saccharomyces boulardii at 640 mg, 3 times a day. The 500-mg, twice daily dose appears to be a standard dose. Clostridium difficile responds well to metronidazole or vancomycin, but a small percentage of individuals have recurrent diarrhea. Probiotics appear to be of benefit in normalizing the fecal flora in these individuals, with controlled trials of Saccharomyces boulardii showing benefit, and studies for Lactobacillus GG showing less efficacy. " Prebiotics and Probiotics for Gastrointestinal Health, " Marteau P, Clin Nutr, 2001;20(Suppl. 1):41-45. Proven effects of probiotics in the gastrointestinal tract include improvement in lactose digestion and other direct enzymatic effects; benefit in antibiotic-associated diarrhea, such as with Clostridium difficile, in which Saccharomyces boulardii, Lactobacillus rhamnosus GG and Enterococcus faecium SF68 have shown benefit; " Nutritional Advantages of Probiotics and Prebiotics, " Marteau P, Boutron-Ruault MC, Br J Nutr, 2002;87(Suppl 2):S153-S157 There is a considerable amount of evidence for the positive effects of some prebiotic substances that stimulate beneficial bacterial ecology, alleviate constipation and treat hepatic encephalopathy. There was a lesser degree of evidence for prebiotics preventing colon cancer, intestinal infection and recurrence of inflammatory bowel disease. There is a high degree of evidence for the positive effect of some probiotics in alleviating lactose intolerance, antibiotic-associated intestinal disorders and gastroenteritis. There is rapidly accumulating evidence that probiotics may also prevent the recurrence of inflammatory bowel diseases. There have been positive trials in preventing gut pathogens, including Clostridium difficile and Helicobacter pylori. Beneficial probiotics include the yeast Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus plantarum LP299v and Enterococcus faecium SF68. Bifidobacterium bifidum and Streptococcus thermophilus have also been shown to be of benefit in infants admitted to the hospital for diarrhea. >________________________________ > >To: rd-usa >Sent: Monday, November 28, 2011 5:36 PM >Subject: Re: C. Difficile > >A systematic review from the Cochrane Library: > >Pillal A, R. Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database of Systematic Reviews. 2008;23:CD004611. > >AUTHORS' CONCLUSIONS: >There is insufficient evidence to recommend probiotic therapy as an adjunct to antibiotic therapy for C. difficile colitis. There is no evidence to support the use of probiotics alone in the treatment of C. difficile colitis. > >Pam Charney, PhD, RD >Affiliate Associate Professor >Pharmacy > >MS Student >Clinical Informatics and Patient Centered Technology >School of Nursing > >University of Washington >Seattle, WA >pcharney@... >http://www.linkedin.com/in/pamcharney > > > > > >> Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. >> >> Thanks! >> >> >> >> >________________________________ >> > >> >To: " rd-usa " <rd-usa > >> >Cc: " RD-USA (rd-usa ) " <rd-usa > >> >Sent: Monday, November 28, 2011 1:50 PM >> >Subject: Re: C. Difficile >> > >> >Diff Stat powder Pak 2gm x 30 d is a popular order here. >> >Sacharomyces Boulardii and bacillus Cogulan w FOS. >> >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. >> > >> > Osowski MS, RD, LD >> >Registered Dietitian >> >Sent from my iPhone >> > >> > >> > >> >> Does anyone have a specific probiotic recommendation for C. Difficile? >> >> >> >> Thank you >> >> >> >> Mazarin, MS, RD, CNS >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2011 Report Share Posted November 28, 2011 , Try to review the process behind the systematic review. Human nature, when we are looking for information to support something that we want to do, is to find information that does just that..... supports what we want to do. In other words, when you found the studies you quote, what was your search strategy? Did you search using several different iterations of terms, in more than one database? Did you hand search through papers to find citations that might have been missed? Did you use a valid rubric to evaluate each study? It looks to me that several of the studies that you cite are fairly old. What has been published since 2003? Systematic reviews are costly, time consuming, and require exquisite attention to detail. It can take many hours to thoroughly review one study. Sometimes there are lots of studies, but none are considered of high quality. Sometimes a lot of positive studies that are not high quality can be offset by one high quality negative study. Studies may not have sufficient power to demonstrate a difference. External validity threats may make it impossible to apply the results of one study to a given situation. Meta-analysis helps sift through all that. And sometimes systematic reviews give results that we don't want to hear! Most likely very few have the time and ability to conduct a systematic review on their own. The Cochrane Library is a fantastic source for systematic reviews on hundreds of topics. Archie Cochran was a British epidemiologist who felt strongly that careful evaluation of biomedical literature could guide safe, high quality healthcare. Since it's beginning, it's grown to become an independent international collaboration of over 20,000 healthcare who strive to find, evaluate and synthesize the best available literature. It's all voluntary. In fact, you can volunteer to author a systematic review through the Cochrane Collaboration. There are also resources available through AHRQ (www.ahrq.gov). I find AHRQ to be a bit more quirky and slightly difficult to navigate, and so tend to turn to the Cochrane group. ADA also has the Evidence Analysis Library (EAL), but that's more limited in scope. I have taught graduate courses and done workshops in the systematic review process and how to review the literature. Students and attendees are always somewhat surprised to learn how much work goes into this process. Regards, pam Pam Charney, PhD, RD Pamela Charney and Associates, LLC consultants in nutrition informatics Transforming Nutrition Care With Informatics pcharney@... http://www.linkedin.com/in/pamcharney " Those who say it can't be done are usually interrupted by those doing it. " -- Baldwin > I wonder how they came to that conclusion when I find many research articles to the contrary? > > > > This study is the first demonstration that the S. boulardii protease inhibits the action of both C. difficile toxins in human colon and that it may be relevant to the mechanism by which this nonpathogenic yeast exerts its beneficial effects in human C. difficile colitis. To our knowledge this is a unique mechanism of action for a biotherapeutic agent. > > http://iai.asm.org/content/67/1/302.full > > " Prevention of Antibiotic-Associated Diarrhea by Saccharomyces boulardii: A Prospective Study, " Surawicz CM, Elmer GW, Speelman P, et al, Gastroenterology, April 1989;96(4):981-988. > In a prospective, double-blind, controlled study investigating antibiotic-associated diarrhea in hospitalized patients, over a 23-month period in 180 subjects who completed the study, it was found that 22% of the placebo subjects experienced diarrhea compared with 9.5% of those who received antibiotics plus lyophilized Saccharomyces boulardii concurrently at a dose of 1 g daily (two 250 mg capsules, b.i.d.). Of the Clostridium difficile-positive patients, 31% receiving placebo developed diarrhea compared with 9.4% who were taking S. boulardii. There were no adverse effects with the yeast administration. > > > " The Use of Probiotics in Gastrointestinal Disease, " Madsen KL, Can J Gastroenterol, December 2001;15(12):817-822. > > Lactobacillus GG alone, or in combination with Bifidobacterium bifidum and Streptococcus thermophilus, has been shown to be effective in the treatment of Clostridium difficile. Prevention of antibiotic-induced diarrhea has occurred with the concomitant supplementation of Lactobacillus GG or Saccharomyces boulardii. Lactobacillus GG at a dose of 1x1010 viable microorganisms per day and the yeast Saccharomyces boulardii at a dose of 1 g/day have frequently been shown to be successful in studies > > " Saccharomyces boulardii Protease Inhibits the Effects of Clostridium difficile Toxins A and B in Human Colonic Mucosa. " Castagliuolo I, Riegler MF, Valenick L, et al, Infect Immun, January 1999;67(1):302-307. > > Anti-protease immunoglobulin G (IgG) prevents the action of Saccharomyces boulardii on toxin A-induced intestinal secretion and mucosal permeability to [3H] mannitol in rat ileal loops and also prevents the effects of S. boulardii protease on digestion of toxins A and B and on binding of [3H] toxin A and [3H] toxin B to purified human colonic brush border membrane. Purified S. boulardii protease reversed toxin A-and toxin B-induced inhibition of protein synthesis in human colonic (HT-29) cells. Toxin A-and B-induced drops in transepithelial resistance in human colonic mucosa occurring in Ussing chambers were reversed by 60% and 68%, respectively, by preexposing the toxins to S. boulardii protease. The effect of S. boulardii on Clostridium difficile-induced inflammatory diarrhea in humans may be due, in part, to proteolytic digestion of toxin A and B molecules by a secreted protease. > > > > " Probiotics, Antibiotic-Associated Diarrhoea and Clostridium difficile Diarrhoea in Humans, " Surawicz CM, Best Pract Res Clin Gastroenterol, 2003;17(5):775-783. > > Diarrhea from antibiotics can occur in up to 29% of patients who are hospitalized, although this happens at a lesser percentage in outpatients. Lactobacillus rhamnosus GG and Saccharomyces boulardii are probiotics which have been shown to reduce antibiotic-associated diarrhea. Probiotic therapy in the treatment of recurrent Clostridium difficile-associated diarrhea shows fair results utilizing Lactobacillus GG and very good results using Saccharomyces boulardii. An early uncontrolled unblinded or open trial of Saccharomyces boulardii at 500 mg, twice daily, showed benefit in recurrent Clostridium difficile-associated diarrhea in adults, as did another open trial of Saccharomyces boulardii at 640 mg, 3 times a day. The 500-mg, twice daily dose appears to be a standard dose. Clostridium difficile responds well to metronidazole or vancomycin, but a small percentage of individuals have recurrent diarrhea. Probiotics appear to be of benefit in normalizing the > fecal flora in these individuals, with controlled trials of Saccharomyces boulardii showing benefit, and studies for Lactobacillus GG showing less efficacy. > > " Prebiotics and Probiotics for Gastrointestinal Health, " Marteau P, Clin Nutr, 2001;20(Suppl. 1):41-45. > Proven effects of probiotics in the gastrointestinal tract include improvement in lactose digestion and other direct enzymatic effects; benefit in antibiotic-associated diarrhea, such as with Clostridium difficile, in which Saccharomyces boulardii, Lactobacillus rhamnosus GG and Enterococcus faecium SF68 have shown benefit; > > " Nutritional Advantages of Probiotics and Prebiotics, " Marteau P, Boutron-Ruault MC, Br J Nutr, 2002;87(Suppl 2):S153-S157 > > There is a considerable amount of evidence for the positive effects of some prebiotic substances that stimulate beneficial bacterial ecology, alleviate constipation and treat hepatic encephalopathy. There was a lesser degree of evidence for prebiotics preventing colon cancer, intestinal infection and recurrence of inflammatory bowel disease. There is a high degree of evidence for the positive effect of some probiotics in alleviating lactose intolerance, antibiotic-associated intestinal disorders and gastroenteritis. There is rapidly accumulating evidence that probiotics may also prevent the recurrence of inflammatory bowel diseases. There have been positive trials in preventing gut pathogens, including Clostridium difficile and Helicobacter pylori. Beneficial probiotics include the yeast Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus plantarum LP299v and Enterococcus faecium SF68. Bifidobacterium bifidum and Streptococcus > thermophilus have also been shown to be of benefit in infants admitted to the hospital for diarrhea. > > > > > >________________________________ > > > >To: rd-usa > >Sent: Monday, November 28, 2011 5:36 PM > >Subject: Re: C. Difficile > > > >A systematic review from the Cochrane Library: > > > >Pillal A, R. Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database of Systematic Reviews. 2008;23:CD004611. > > > >AUTHORS' CONCLUSIONS: > >There is insufficient evidence to recommend probiotic therapy as an adjunct to antibiotic therapy for C. difficile colitis. There is no evidence to support the use of probiotics alone in the treatment of C. difficile colitis. > > > >Pam Charney, PhD, RD > >Affiliate Associate Professor > >Pharmacy > > > >MS Student > >Clinical Informatics and Patient Centered Technology > >School of Nursing > > > >University of Washington > >Seattle, WA > >pcharney@... > >http://www.linkedin.com/in/pamcharney > > > > > > > > > > > >> Hi , do you know what the reasoning behind that is? (not having to dose apart from ATB). Incidentally, my son was prescribed Florastor last December in conjunction with MRSA antibiotic but wasn't told to take them at separate times. Since Florastor is a yeast based probiotic, I'm just curious why some think the Florastor has to be given at different times than an antibiotic designed to kill bacteria. > >> > >> Thanks! > >> > >> > >> > >> >________________________________ > >> > > >> >To: " rd-usa " <rd-usa > > >> >Cc: " RD-USA (rd-usa ) " <rd-usa > > >> >Sent: Monday, November 28, 2011 1:50 PM > >> >Subject: Re: C. Difficile > >> > > >> >Diff Stat powder Pak 2gm x 30 d is a popular order here. > >> >Sacharomyces Boulardii and bacillus Cogulan w FOS. > >> >It doesn't have to be dosed 2 hours apart from ATB as Florastor does. > >> > > >> > Osowski MS, RD, LD > >> >Registered Dietitian > >> >Sent from my iPhone > >> > > >> > > >> > > >> >> Does anyone have a specific probiotic recommendation for C. Difficile? > >> >> > >> >> Thank you > >> >> > >> >> Mazarin, MS, RD, CNS > >> >> > >> >> Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.