PMID- 24044687
OWN - NLM
STAT- MEDLINE
DCOM- 20140408
LR  - 20221207
IS  - 1475-2662 (Electronic)
IS  - 0007-1145 (Linking)
VI  - 111
IP  - 4
DP  - 2014 Feb
TI  - A Lactobacillus casei Shirota probiotic drink reduces antibiotic-associated 
      diarrhoea in patients with spinal cord injuries: a randomised controlled trial.
PG  - 672-8
LID - 10.1017/S0007114513002973 [doi]
AB  - Certain probiotics may prevent the development of antibiotic-associated diarrhoea 
      (AAD) and Clostridium difficile-associated diarrhoea (CDAD), but their 
      effectiveness depends on both strain and dose. There are few data on nutritional 
      interventions to control AAD/CDAD in the spinal cord injury (SCI) population. The 
      present study aimed to assess (1) the efficacy of consuming a commercially 
      produced probiotic containing at least 6.5 x 10(9) live Lactobacillus casei Shirota 
      (LcS) in reducing the incidence of AAD/CDAD, and (2) whether undernutrition and 
      proton pump inhibitors (PPI) are risk factors for AAD/CDAD. A total of 164 SCI 
      patients (50.1 (sd 17.8) years) with a requirement for antibiotics (median 21 d, 
      range 5-366) were randomly allocated to receive LcS (n 76) or no probiotic (n 
      82). LcS was given once daily for the duration of the antibiotic course and 
      continued for 7 days thereafter. Nutritional risk was assessed by the Spinal 
      Nutrition Screening Tool. The LcS group had a significantly lower incidence of 
      AAD (17.1 v. 54.9%, P< 0.001). At baseline, 65% of patients were at 
      undernutrition risk. Undernutrition (64.1 v. 33.3%, P< 0.01) and the use of PPI 
      (38.4 v. 12.1 %, P= 0.022) were found to be associated with AAD. However, no 
      significant difference was observed in nutrient intake between the groups. The 
      multivariate logistic regression analysis identified poor appetite ( < 1/2 meals 
      eaten) (OR 5.04, 95% CI 1.28, 19.84) and no probiotic (OR 8.46, 95% CI 3.22, 
      22.20) as the independent risk factors for AAD. The present study indicated that 
      LcS could reduce the incidence of AAD in hospitalised SCI patients. A randomised, 
      placebo-controlled study is needed to confirm this apparent therapeutic success 
      in order to translate into improved clinical outcomes.
FAU - Wong, Samford
AU  - Wong S
AD  - National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury HP21 8AL, 
      UK.
FAU - Jamous, Ali
AU  - Jamous A
AD  - National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury HP21 8AL, 
      UK.
FAU - O'Driscoll, Jean
AU  - O'Driscoll J
AD  - Department of Microbiology, Stoke Mandeville Hospital, Aylesbury HP21 8AL, UK.
FAU - Sekhar, Ravi
AU  - Sekhar R
AD  - Department of Gastroenterology, Stoke Mandeville Hospital, Aylesbury HP21 8AL, 
      UK.
FAU - Weldon, Mike
AU  - Weldon M
AD  - Department of Gastroenterology, Stoke Mandeville Hospital, Aylesbury HP21 8AL, 
      UK.
FAU - Yau, Chi Y
AU  - Yau CY
AD  - Medicine for Older People, Stoke Mandeville Hospital, Aylesbury HP21 8AL, UK.
FAU - Hirani, Shashivadan P
AU  - Hirani SP
AD  - School of Community and Health Science, City University, London EC1V 0HB, UK.
FAU - Grimble, George
AU  - Grimble G
AD  - Centre for Gastroenterology and Clinical Nutrition, University College London, 
      London WC1E 6BT, UK.
FAU - Forbes, Alastair
AU  - Forbes A
AD  - Centre for Gastroenterology and Clinical Nutrition, University College London, 
      London WC1E 6BT, UK.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20130918
PL  - England
TA  - Br J Nutr
JT  - The British journal of nutrition
JID - 0372547
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Bacterial Agents/*adverse effects/therapeutic use
MH  - Appetite
MH  - Clostridioides difficile
MH  - Diarrhea/epidemiology/etiology/*prevention & control
MH  - Double-Blind Method
MH  - Energy Intake
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Incidence
MH  - *Lacticaseibacillus casei
MH  - Logistic Models
MH  - Male
MH  - Malnutrition/*complications
MH  - Meals
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Nutritional Status
MH  - Probiotics/*therapeutic use
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Risk Factors
MH  - Spinal Cord Injuries/*complications/drug therapy
MH  - Treatment Outcome
EDAT- 2013/09/21 06:00
MHDA- 2014/04/09 06:00
CRDT- 2013/09/19 06:00
PHST- 2013/09/19 06:00 [entrez]
PHST- 2013/09/21 06:00 [pubmed]
PHST- 2014/04/09 06:00 [medline]
AID - S0007114513002973 [pii]
AID - 10.1017/S0007114513002973 [doi]
PST - ppublish
SO  - Br J Nutr. 2014 Feb;111(4):672-8. doi: 10.1017/S0007114513002973. Epub 2013 Sep 
      18.