Cited by 44Probiotics and Fermented FoodsClostridium difficile and Clostridium perfringens researchGut microbiota and health

Which probiotic has the best effect on preventing Clostridium difficile‐associated diarrhea? A systematic review and network meta‐analysis

Ma, Yan, Yang, Jing Yu, Peng, Xia, Xiao, Ke Yi, Xu, Qing, Wang, Chen·2020·Journal of Digestive Diseases

Abstract

OBJECTIVE: Clostridium difficile-associated diarrhea (CDAD) accounts for up to 25% of patients with antibiotic-associated diarrhea (AAD). We aimed to determine which probiotic is most effective in preventing CDAD using a network meta-analysis. METHODS: Studies were identified by searching PubMed, EMBASE and the Cochrane Library databases for randomized controlled trials (RCTs) that evaluated the efficacy of probiotic interventions for CDAD. Primary outcomes were the incidence rates of AAD and CDAD, and secondary outcomes were the duration of diarrhea and the time until onset of diarrhea. The PROSPERO registered number of this study is CRD42018106115. RESULTS: Ten RCTs including 11 analyses and including 4 692 patients were identified. Compared with the control group, probiotic intervention reduced the incidence rates of CDAD (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.17-0.61) and AAD (OR 0.39, 95% CI 0.23-0.66). Similar results were observed regarding the duration of diarrhea and the time until onset of diarrhea. Meta-regression analysis showed a correlation between the type of probiotic used and the incidence of CDAD and AAD. All nine kinds of probiotic interventions were statistically more effective than the placebo, with Lactobacillus casei ranking as the best intervention (OR 0.19, 95% credible interval [CrI] 0.06-0.63) for decreasing the incidence rate of CDAD. L. casei also ranked the highest in reducing the incidence rate of AAD (OR 0.32, 95% CrI 0.14-0.74). CONCLUSION: Lactobacilli strains, especially L. casei, have a good effect on the prevention of CDAD and AAD.

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Crossref · 10.1111/1751-2980.12839

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Authors
Ma, Y., Yang, J. Y., Peng, X., Xiao, K. Y., Xu, Q., & Wang, C.
Affiliations
  • Shenyang Normal University (CN)
  • The Sixth People's Hospital of Shenyang (CN)
  • Liaoning Academy of Agricultural Sciences (CN)
Corresponding author
  • Xu, Qing
  • Wang, Chen
Venue
Journal of Digestive Diseases
Publisher
Wiley
Published
2020-02
Volume
21
Issue
2
Pages
69-80
ISSN
  • 1751-2972 (ISSN-L)
  • 1751-2980
OpenAlex
W2997390250
Cited by
44
References
39
Citations by year
2026: 4 · 2025: 7 · 2024: 11 · 2023: 4 · 2022: 6 · 2021: 7 · 2020: 5
FWCI
0.41
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Digestive Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
Clostridium difficile-associated diarrhea, probiotics, antibiotic-associated diarrhea, Lactobacillus casei, Lactobacillus, diarrhea prevention, diarrhea duration
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Child, Clostridium Infections, Diarrhea, Enterocolitis, Pseudomembranous, Female, Humans, Male, Middle Aged, Odds Ratio, Randomized Controlled Trials as Topic, Clostridioides difficile, Treatment Outcome, Probiotics

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