PREVENTION OF RELAPSE FOLLOWING CLOSTRIDIUM DIFFICILE INFECTION USING PROBIOTIC LACTOBACILLUS CASEI SHIROTA.

Once patients have had Clostridium difficile infection (CDI), recurrence rates are high with many patients experiencing a relapse of their disease. Lactobacillus casei Shirota is a probiotic that reduces rates of antibiotic-associated diarrhoea. There have been no studies analyzing the use of this probiotic in patients who have had an episode of CDI to prevent relapse. This study was a single site, cohort-control study of patients with CDI and treated with either antibiotics alone or antibiotics and probiotics (L. casei Shirota). 66 patients were included for analysis in this study, 31 had probiotics and antibiotics and 35 who had no-probiotics. The median age of the patients was 78 years and 33.3 % were male. Rates of recurrent CDI were significantly lower in the probiotics cohort, 3.2% vs 20.0% (p=0.007). We conclude, patients who have had CDI have a high rate of early re-admissions to hospital with significant morbidity and mortality. This study suggests that the use of the widely available probiotic strain L. casei Shirota at the time of initial infection may be associated with lower rates of CDI recurrence and lower readmission rates. Further prospective studies are required. [ABSTRACT FROM AUTHOR]