Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine if the use of probiotics can prevent the incidence of antibiotic-associated diarrhea (AAD) in adults using one or more antibiotics.
STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language published between 2013 and 2014.
DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed and Cochrane databases.
OUTCOME MEASURED: All three studies defined diarrhea as the passage of three or more loose stools in a 24-hour period. All the studies used the Bristol Stool Scale. Stool consistency and frequency was recorded by patients, relatives, or clinical staff.
RESULTS: Three double-blind, placebo-controlled trials were included and analyzed in this review. None of the three studies showed a statistical significance in AAD between their control groups and the groups receiving probiotics. The Chatterjee et al. study had a p-value of 0.19 and a Numbers Needed to Treat (NNT) of -20.83, the Wright et al. study had a p-value of 0.729 and a NNT of 28.57, and the Allen et al. study had a p-value of 0.72 and a NNT of 250.
CONCLUSION: The three double-blind, placebo-controlled trials analyzed in this review showed no benefit in the use of probiotics for the prevention of AAD when comparing the placebo groups and the probiotics groups.
Castillo, David E., "Does the use of prophylactic probiotics prevent antibiotic-associated diarrhea in adults using one or more antibiotics?" (2017). PCOM Physician Assistant Studies Student Scholarship. 380.