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Concurrent Probiotic and Antibiotic Use for In-Patients: Clinical Effectiveness and Cost-Effectiveness

Last updated: November 9, 2015
Project Number: RC0727-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness, including safety, of concurrent probiotic and antibiotic use for in-patients?
  2. What is the cost-effectiveness of concurrent probiotic and antibiotic use for in-patients?

Key Message

Two systematic reviews (SRs)/meta-analyses (MAs) and one randomized controlled trial (RCT) on adult in-patients reported protective effects of probiotics on the incidences of antibiotic-associated diarrhea (AAD), Clostridium difficile-associated diarrhea (CDAD), Clostridium difficile infection (CDI), and Clostridium difficile disease (CDD) as well as the incidence of adverse events. One SR/MA on adult in-patients reported that, although there is suggestive evidence that probiotics may be effective in preventing CDAD, it was not strong enough to be the basis for a general policy change. One RCT on adult in-patients, aged 65 years or older, found no protective effects of probiotics on the incidences of AAD, CDAD, and adverse events as well as on hospital length of stay (LOS). Evidence from one economic evaluation that was conducted alongside the aforementioned RCT on adult in-patients, aged 65 years or older, suggested that the intervention was unlikely to be cost-effective.