#4 Probiotics for the Prevention of Antibiotic-Associated Diarrhea

What's the Proof?

In this episode, the What's the Proof team is shocked by the practice-changing evidence surrounding the use of probiotics in preventing antibiotic-associated diarrhea.
Also, in "Residents Ask the Darnedest Things," Dr. Caviness shares what she learned when a medical student asked about co-testing for influenza along with COVID-19 in symptomatic patients.
Most Studied Probiotics:
In adults: Saccharomyces boulardii, Lactobacillus acidophilus, Lactobacillus casei

• Dose: 10 to 50 billion CFUs per day

In children: Lactobacillus rhamnosus, Saccharomyces boulardii

• "High-dose": >5 billion CFUs per day

Episode Outline:

• Intro/background 02:00
• Evidence for use in adults 08:20
• Potential harms 15:29
• Which probiotics are recommended? 16:29
• Evidence for use in children 20:08
• "Residents Ask The Darnedest Things" 28:09

Links from this episode:

• 2017 Cochrane review "Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children" https://pubmed.ncbi.nlm.nih.gov/29257353/
• 2010 RCT on use of probiotics for AAD and CDAD in hospitalized adults https://pubmed.ncbi.nlm.nih.gov/29257353/
• 2019 Cochrane Review "Probiotics for the prevention of pediatric antibiotic-associated diarrhea" https://pubmed.ncbi.nlm.nih.gov/31039287/

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Credits:

• Hosts: Bobby Scott, MD, FAAFP; Sandy Robertson, PharmD; Dawn Caviness, MD, BSN
• Production & Cover Art: Bobby Scott, MD, FAAFP
• Music: Twisterium, MondayHopes, Muzaproduction, and SergeQuadrado from Pixabay