Prophylactic Use of Probiotic (Infloran®) to Prevent Antibiotic Associated Diarrhea in Medical Ward Patients at Rajavithi Hospital

Background: Antibiotic associated diarrhea and Clostridium difficile associated diarrhea are complications of treatment with antimicrobial agents and occur in about 5-25% of patients. Several studies conducted in Western countries have supported the benefits of probiotics for the prevention and treatment of antibiotic associated diarrhea. Aims: To evaluate the efficacy and safety of probiotic (Infloran ® ) for the prevention of antibiotic associated diarrhea and C. difficile associated diarrhea in adult patients. Methods: A randomized, double-blind, placebo-controlled study was conducted in 50 patients admitted to the Internal Medicine Ward, Rajavithi Hospital, Bangkok. Patients were randomized to receive either 1 capsule of Infloran ® or an identical-looking placebo three times daily for 14 days, and were followed up for one month to observe the occurrence of antibiotic associated diarrhea and C. difficile associated diarrhea. Results: Three out of twenty-six patients (11.5%) in the Infloran ® group developed antibiotic associated diarrhea, compared with none in the placebo group (p = 0.246). One diarrhea patient was shown to harbour C. difficile toxin. The most common side effects were bloating and abdominal distension which occurred developed in the Infloran ® group more often than in the placebo group, but without a significant difference (p = 0.369). Conclusion: In this study, Infloran ® at the dosage of 1 capsule three times daily for 14 days did not prevent antibiotic associated diarrhea and C. difficile associated diarrhea. The most common side effects of Infloran ®