Use of probiotic Lactobacillus preparation to prevent C.difficile diarrhoea associated with antibiotics: Interrupted time series study

Project summary

Background and methods

Evidence is accumulating to support the use of probiotic products in the prevention of antibiotic associated diarrhoea and specifically Clostridium difficile (C.difficile) associated diarrhoea. A recent randomised control trial provides good evidence that a product containing the live bacteria L casei DN114001, L bulgaricus and S thermophilus (Actimel, Danone, France) can prevent these conditions. However, further evidence is required to support this intervention in routine hospital practice.

This is an interrupted time series study to explore the impact of routine use of this probiotic product on C.difficile rates. The aim is to test the hypothesis that providing a probiotic drink containing L casei DN114001, L bulgaricus and S thermophilus (Actimel) twice daily to all patients within the medical directorate will reduce rates of C.difficile within this directorate.

Primary outcome:

Overall C.difficile rates within the Medicine Directorate.

Secondary outcomes:

A – Proportions of each strain type causing infections during the trial.

B – Adherence to probiotic drink

C – Length of stay

D – Readmission rates to the Trust

Economic outcomes:

A costing analysis will be carried out to assess the incremental cost of delivering care with the probiotic intervention as compared with conventional care.