PMID- 38519563
OWN - NLM
STAT- Publisher
LR  - 20240323
IS  - 1476-5624 (Electronic)
IS  - 1362-4393 (Linking)
DP  - 2024 Mar 22
TI  - Lactobacillus casei Shirota probiotic drinks reduce antibiotic associated 
      diarrhoea in patients with spinal cord injuries who regularly consume proton pump 
      inhibitors: a subgroup analysis of the ECLISP multicentre RCT.
LID - 10.1038/s41393-024-00983-w [doi]
AB  - STUDY DESIGN: This was a sub-group analysis of a multicentre, randomised, 
      placebo-controlled, double-blind trial (ECLISP trial) OBJECTIVES: To assess the 
      efficacy of a probiotic containing at least 6.5 x 10(9) live Lactobacillus casei 
      Shirota (LcS) in preventing antibiotic associated diarrhoea (AAD) in patients 
      with spinal cord injury (SCI) who consumed proton pump inhibitor (PPI) regularly. 
      LcS or placebo was given once daily for the duration of an antibiotic course and 
      continued for 7 days thereafter. The trial was registered with ISRCTN:13119162. 
      SETTING: Three SCI centres (National Spinal Injuries Centre, Midland Centre for 
      Spinal Injuries and Princess Royal Spinal Cord Injuries Centre) in the United 
      Kingdom METHODS: Between November 2014, and November 2019, 95 eligible consenting 
      SCI patients (median age: 57; IQ range: 43-69) were randomly allocated to receive 
      LcS (n = 50) or placebo (n = 45). The primary outcome is the occurrence of AAD up 
      to 30 days after finishing LcS/placebo. RESULTS: The LcS group had a 
      significantly lower incidence of AAD at 30 days after finishing the antibiotic 
      course (28.0 v 53.3%, RR: 95% CI: 0.53, 0.31-0.89; z = 2.5, p = 0.01). 
      Multivariate logistic regression analysis identified that LcS can reduce the risk 
      of AAD at 30 days (OR: 0.36, 95% CI 0.13, 0.99, p < 0.05). No 
      intervention-related adverse events were reported during the study. CONCLUSIONS: 
      LcS has the potential to prevent AAD in what could be considered a defined 
      vulnerable group of SCI patients on regular PPI. A confirmatory, randomised, 
      placebo-controlled study is needed to confirm this apparent therapeutic success 
      to translate it into appropriate clinical outcomes. SPONSORSHIP: Yakult Honsha 
      Co., Ltd.
CI  - (c) 2024. Crown.
FAU - Wong, Samford
AU  - Wong S
AUID- ORCID: 0000-0002-3975-5684
AD  - National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. 
      samford.wong.1@city.ac.uk.
AD  - School of Health & Psychological Sciences, City, University of London, London, 
      UK. samford.wong.1@city.ac.uk.
AD  - Royal Buckinghamshire Hospital, Aylesbury, UK. samford.wong.1@city.ac.uk.
FAU - Hirani, Shashivadan P
AU  - Hirani SP
AD  - School of Health & Psychological Sciences, City, University of London, London, 
      UK.
FAU - Forbes, Alastair
AU  - Forbes A
AD  - University of Tartu, Estonia, and Norwich Medical School, University of East 
      Anglia, Norwich, UK.
FAU - Kumar, Naveen
AU  - Kumar N
AD  - Midland Centre for Spinal Injury, Robert Jones and Agnes Hunt Orthopaedic 
      Hospital, Gobowen, UK.
FAU - Hariharan, Ramaswamy
AU  - Hariharan R
AD  - The Princess Royal Spinal Injuries Centre, Northern General Hospital, Sheffield, 
      UK.
FAU - O'Driscoll, Jean
AU  - O'Driscoll J
AD  - Department of Microbiology, Stoke Mandeville Hospital, Aylesbury, UK.
FAU - Sekhar, Ravi
AU  - Sekhar R
AD  - Department of Gastroenterology, Stoke Mandeville Hospital, Aylesbury, UK.
FAU - Jamous, Ali
AU  - Jamous A
AD  - INRES Neuro, Wendover, UK.
LA  - eng
PT  - Journal Article
DEP - 20240322
PL  - England
TA  - Spinal Cord
JT  - Spinal cord
JID - 9609749
SB  - IM
EDAT- 2024/03/23 20:43
MHDA- 2024/03/23 20:43
CRDT- 2024/03/23 00:32
PHST- 2023/06/13 00:00 [received]
PHST- 2024/03/13 00:00 [accepted]
PHST- 2024/03/08 00:00 [revised]
PHST- 2024/03/23 20:43 [medline]
PHST- 2024/03/23 20:43 [pubmed]
PHST- 2024/03/23 00:32 [entrez]
AID - 10.1038/s41393-024-00983-w [pii]
AID - 10.1038/s41393-024-00983-w [doi]
PST - aheadofprint
SO  - Spinal Cord. 2024 Mar 22. doi: 10.1038/s41393-024-00983-w.