How soon should they be administered and which probiotics were the most effective in preventing C. Difficile in hospitals?

Dr. Shen and her colleagues conducted a literature search and identified 19 studies published from 1989 to 2016 (including PLACIDE) that involved 6942 hospitalized adults taking antibiotics and receiving either a probiotic or placebo as prevention for C difficile infection. There was a significant difference in the incidence of infection between the probiotic and placebo groups (incidence, 1.5% vs 3.5%).

The pooled results show “robust efficacy” for probiotics in the prevention of C difficile infection (risk ratio, 0.41; 95% confidence interval, 0.30 – 0.57; P < .001). The greatest probiotic efficacy was seen in studies with the highest incidence of infection.

So, which probiotics were the most effective, you might be wondering? Among the nine different probiotics used in the studies, several appeared to perform better than others in preventing C. diff, but the differences were not significant enough to recommend using one over the others. Significantly, probiotics given within 2 days of the antibiotic were found to be more effective than those given later.

The available evidence strongly suggests the use of probiotics significantly reduces the risk of CDI in hospitalized patients taking antibiotics and that further studies are not needed to establish efficacy.

Read more specifics about the study here.