SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2005
Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 37 papers, 6 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 6 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Probiotics for the prevention of Clostridioides difficile-associated diarrhea in adults and children.The Cochrane database of systematic reviews · 2025Pooled it
- A practical guide for probiotics applied to the case of antibiotic-associated diarrhea in The Netherlands.BMC gastroenterology · 2018Guideline
- Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.The Cochrane database of systematic reviews · 2017Pooled it
- Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta-analysis.Open medicine : a peer-reviewed, independent, open-access journal · 2013Pooled it
- Pooled it
- 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 · 2006Pooled it
- Bacterial probiotics as an aid in the control of Clostridium difficile disease in neonatal pigs.The Canadian veterinary journal = La revue veterinaire canadienne · 2016Trial
- A Critical Review of Postbiotics as Promising Novel Therapeutic Agents for Clostridial Infections.Probiotics and antimicrobial proteins · 2025Review
- Genome Sequence of a Clostridioides difficile Strain Isolated from Feces from a Patient in Southern Thailand.Microbiology resource announcements · 2023Article
- Comparison of the gut microbiome composition among individuals with acute or long-standing spinal cord injury vs. able-bodied controls.The journal of spinal cord medicine · 2022Article
- Article
- Clinical Significance of Toxigenic Clostridioides difficile Growth in Stool Cultures during the Era of Nonculture Methods for the Diagnosis of C. difficile Infection.Microbiology spectrum · 2021Article
- Guidelines forPrzeglad gastroenterologiczny · 2020Article
- Use of antibiotic and prevalence of antibiotic-associated diarrhoea in-patients with spinal cord injuries: a UK national spinal injury centre experience.Spinal cord · 2017Article
- Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies.Clinical microbiology reviews · 2017Review
- Assessing worldwide research activity on probiotics in pediatrics using Scopus database: 1994-2014.The World Allergy Organization journal · 2016Article
- Review
- A Double-Blind, Randomized, Active Drug Comparative, Parallel-Group, Multi-Center Clinical Study to Evaluate the Safety and Efficacy of Probiotics (Bacillus licheniformis, Zhengchangsheng® capsule) in Patients with Diarrhea.Intestinal research · 2014Article
- Clinical update for the diagnosis and treatment of Clostridium difficile infection.World journal of gastrointestinal pharmacology and therapeutics · 2014Review
- The simple predictors of pseudomembranous colitis in patients with hospital-acquired diarrhea: a prospective observational study.Gut and liver · 2014Observational
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe recent increase in the number and severity of cases of nosocomial Clostridium difficile-associated diarrhea (CDAD) has prompted interest in the use of probiotics for the prevention and treatment of this disease. We performed a systematic review of randomized controlled trials to assess the effectiveness of probiotic therapy.
methodsWe searched the PubMed, EMBASE, INAHTA, HEN and Cochrane Collaboration databases to identify trials in which the prevention or treatment of CDAD with probiotic therapy was the primary or secondary outcome. We extracted data on the number of patients randomly assigned to receive probiotic or placebo, the number of patients with CDAD, the type of probiotic, criteria for diagnosing CDAD, persistence of infection after treatment, compliance and adverse effects.
resultsWe identified 4 eligible studies in which prevention (n = 1) or treatment (n = 3) of CDAD was the primary outcome. The benefit of probiotic therapy seen in 2 of the studies was restricted to subgroups characterized by severe CDAD and increased use of vancomycin. The remaining 2 studies were too methodologically flawed for us to draw meaningful conclusions. We also identified 4 trials in which prevention of antibiotic-associated diarrhea with probiotics was the primary outcome and prevention of CDAD a secondary outcome. These studies were limited primarily by too few CDAD cases and provided no evidence of effective prophylaxis. Overall, heterogeneity in choice and dose of probiotic and in criteria for diagnosing CDAD makes it difficult to synthesize information from the 8 studies.
interpretationStudies conducted to date provide insufficient evidence for the routine clinical use of probiotics to prevent or treat CDAD. Better designed and larger studies are needed.
Indexed as
Identifiers
What OpenQuestion holds
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.