ABSTRACT
Antibiotic-associated diarrhea (AAD) is a frequent event, both in outpatients and especially in hospitalized subjects as well as in residents of long-term institutions, with incidence ranging from 5 to 30%.1 Broad spectrum antibiotics, such as amoxicillin, cephalosporins, clindamycin, and oroquinolones are the most commonly involved among antibacterial agents.2,3 Between 20 to 30% of cases of AAD are linked to the presence of Clostridium difficile,3 a Gram-positive, anaerobic, sporeforming bacillus that is considered responsible for the large majority of the most severe form of AAD: pseudomembranous colitis. Occasionally other microorganisms, such as Clostridium perfrigens, Klebsiella oxytoca, and Staphylococcus aureus can be implicated.4,5
Clostridium difficile-associated disease (CDAD) is especially frequent in elderly people, hospitalized patients, and in subjects on long-term therapy with either
9.1 Introduction .................................................................................................. 149 9.2 Probiotics in the Prevention of AAD ............................................................ 150
9.2.1 Lactobacilli ....................................................................................... 151 9.2.2 Saccharomyces boulardii ................................................................. 151 9.2.3 Miscellanea ....................................................................................... 152 9.2.4 Meta-Analyses .................................................................................. 152
9.3 Probiotics in the Prevention and Treatment of CDAD ................................. 152 9.3.1 Saccharomyces boulardii ................................................................. 153 9.3.2 Lactobacilli ....................................................................................... 153 9.3.3 Miscellanea ....................................................................................... 153 9.3.4 Prebiotics .......................................................................................... 153
9.4 Conclusions ................................................................................................... 154 References .............................................................................................................. 154
immunosuppressive agents or gastric acid inhibitors, particularly proton pump inhibitors.6
