The effect of Saccharomyces boulardii primary prevention on risk of Hospital Onset Clostridioides difficile infection in hospitalized patients administered antibiotics frequently associated with Clostridioides difficile infection

Link to article at PubMed

Wombwell E, et al. Clin Infect Dis 2020.

ABSTRACT

BACKGROUND: Hospital Onset Clostridioides difficile infection (HO-CDI) is a costly problem leading to readmissions, morbidity and mortality. We evaluated the effect of a single probiotic strain, Saccharomyces boulardii, at a standardized dose on the risk of HO-CDI within hospitalized patients administered antibiotics frequently associated with HO-CDI.

METHODS: This retrospective cohort study merged hospital prescribing data with HO-CDI case data. The study assessed patients hospitalized from January 2016 through March 2017 that were administered at least one dose of an antibiotic frequently associated with HO-CDI during hospitalization. Associations between S. boulardii administration, including timing, and HO-CDI incidence were evaluated by multivariable logistic regression.

RESULTS: The study included 8,763 patients. HO-CDI incidence was 0.66% in the overall cohort. HO-CDI incidence was 0.56% and 0.82% among patients co-administered S. boulardii with antibiotics and not co-administered S. boulardii, respectively. In adjusted analysis, patients co-administered S. boulardii had a reduced risk of HO-CDI (OR=0.57, 95% CI 0.33-0.96, p=0.04) compared to patients not co-administered S. boulardii. Patients co-administered S. boulardii within 24-hours of antibiotic start demonstrated a reduced risk of HO-CDI (OR=0.47, 95% CI 0.23-0.97, p=0.04) compared to those co-administered S. boulardii after 24-hours of antibiotic start.

CONCLUSIONS: S. boulardii administered to hospitalized patients prescribed antibiotics frequently linked with HO-CDI was associated with a reduced risk of HO-CDI.

PMID:32575126 | DOI:10.1093/cid/ciaa808

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