Evidence map›Paper›PMID 12052801›Full record

SynthesisBMJ (Clinical research ed.)2002

Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis.

Aloysius L D'Souza, Chakravarthi Rajkumar, Jonathan Cooke, Christopher J Bulpitt

4 registry-linked trialsAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 127 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
127citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00848003 phase1completednot on this mapstarted 2009, after this paper: background citation

Safety of BB-12 Supplemented Strawberry Yogurt For Healthy Adults on Antibiotics

TypeinterventionalSponsorGeorgetown UniversityRan2009 to 2011Enrolled40ConditionsAdults on AntibioticsArmsBifidobacterium animalis subsp. lactis strain BB-12, Placebo
NCT00973908 phase2 / phase3completednot on this mapstarted 2010, after this paper: background citation

Probiotics for the Prevention of Antibiotics Associated Diarrhoea and Clostridium Difficile Associated Diarrhoea

TypeinterventionalSponsorNational Health Service, United KingdomRan2010 to 2012Enrolled231ConditionsDiarrhoeaArmsVSL#3, Placebo
NCT02819960 phase3completednot on this mapstarted 2016, after this paper: background citation

Prevention of Irinotecan Induced Diarrhea by Probiotics: A Phase III Study

TypeinterventionalSponsorS&D Pharma SK s.r.o.Ran2016 to 2022Enrolled233ConditionsDiarrhea, CancerArmsProbio-Tec® BG-VCap-6.5, Placebo
NCT03150927 naunknown statusnot on this mapstarted 2017, after this paper: background citation

A Clinical Study to Determine the Effects of a Novel Probiotic Microbial Composite™ on Improving Digestive Health and Key Growth Parameters in Undernourished Young Children

TypeinterventionalSponsorBiowish Technologies, Inc.Ran2017 to 2019Enrolled250ConditionsQuality of Life, Malnutrition, Growth ArrestArmsProbiotic Microbial Composite, Placebo
3 · Its place in the literature

Who cites it

127 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  6. Probiotics for the prevention of pediatric antibiotic-associated diarrhea.The Cochrane database of systematic reviews · 2019
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  7. Guideline
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  12. Prevention of Clostridium difficile infection with Saccharomyces boulardii: a systematic review.Canadian journal of gastroenterology = Journal canadien de gastroenterologie · 2009
    Pooled it
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  14. Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2006
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67 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Aloysius L D'SouzaCare of the Elderly Section, Faculty of Medicine, Imperial College School of Medicine, Hammersmith Hospital, London W12 0NN. aloysius.dsouza@ic.ac.uk
Chakravarthi Rajkumar
Jonathan Cooke
Christopher J Bulpitt

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate efficacy of probiotics in prevention and treatment of diarrhoea associated with the use of antibiotics.

designMeta-analysis; outcome data (proportion of patients not getting diarrhoea) were analysed, pooled, and compared to determine odds ratios in treated and control groups. IDENTIFICATION: Studies identified by searching Medline between 1966 and 2000 and the Cochrane Library. Studies reviewed Nine randomised, double blind, placebo controlled trials of probiotics.

resultsTwo of the nine studies investigated the effects of probiotics in children. Four trials used a yeast (Saccharomyces boulardii), four used lactobacilli, and one used a strain of enterococcus that produced lactic acid. Three trials used a combination of probiotic strains of bacteria. In all nine trials, the probiotics were given in combination with antibiotics and the control groups received placebo and antibiotics. The odds ratio in favour of active treatment over placebo in preventing diarrhoea associated with antibiotics was 0.39 (95% confidence interval 0.25 to 0.62; P<0.001) for the yeast and 0.34 (0.19 to 0.61; P<0.01 for lactobacilli. The combined odds ratio was 0.37 (0.26 to 0.53; P<0.001) in favour of active treatment over placebo.

conclusionsThe meta-analysis suggests that probiotics can be used to prevent antibiotic associated diarrhoea and that S boulardii and lactobacilli have the potential to be used in this situation. The efficacy of probiotics in treating antibiotic associated diarrhoea remains to be proved. A further large trial in which probiotics are used as preventive agents should look at the costs of and need for routine use of these agents.

Indexed as

Anti-Bacterial AgentsChildDiarrheaHumansOdds RatioProbioticsRandomized Controlled Trials as TopicTreatment OutcomeAnti-Bacterial Agents

Identifiers

PMID12052801
PMCPMC115209

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.