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WASHINGTON — In hospitalized patients taking antibiotics, coadministration of the probiotic Saccharomyces boulardii can reduce costs, shorten hospital stays, and may save lives, Allyson L. Rovetto and her associates reported in a poster at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Antibiotic-associated diarrhea (AAD) occurs in up to 30% of all hospitalized patients given antibiotics. Clostridium difficile-associated diarrhea (CDAD) is both the most common and the most severe manifestation, with potential complications including colitis, ileitis, toxic megacolon, and death, noted Ms. Rovetto and associates, of Mount Sinai School of Medicine, New York.
Growing evidence suggests that probiotics such as the live, nonpathogenic yeast S. boulardii may be effective in preventing AAD and recurrent CDAD, although that organism is associated with an increased risk for fungemia, which may also lead to severe complications including death (Clin. Infect. Dis. 2005;40:1625–34).
In a study funded in part by the National Center for Complementary and Alternative Medicine of the National Institutes of Health, the investigators used data from published literature to perform a cost-effectiveness analysis of administering vs. not administering S. boulardii along with antibiotics to hospitalized patients.
The probability of CDAD was estimated to be 2% among those given the probiotic along with antibiotics vs. 5% given antibiotics alone. The increase in hospital cost per patient with CDAD was $4,129, and the probability of CDAD complications was 3%. Compared with antibiotics alone, treatment with antibiotics plus the probiotic yielded a cost saving of $81.60 per patient in addition to shortening hospital stays by about 3 days.
Patients older than 65 and those with hospital stays longer than 2 weeks stand to benefit the most. The analysis revealed that even if the protective effect of S. boulardii was halved, it would remain the preferred strategy. In fact, the only way the probiotic's benefit would be offset is if the incidence of fungemia exceeded 2 per 100 patients, “which seems highly unlikely,” they remarked.
But since the rate and potential severity of S. boulardii-associated fungemia is still not clearly defined, “We believe further studies are needed to confirm safety and effectiveness, especially in elderly and other high-risk populations” before issuing any recommendations, coauthor Dr. Henry Sacks said at the meeting sponsored by the American Society for Microbiology.
WASHINGTON — In hospitalized patients taking antibiotics, coadministration of the probiotic Saccharomyces boulardii can reduce costs, shorten hospital stays, and may save lives, Allyson L. Rovetto and her associates reported in a poster at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Antibiotic-associated diarrhea (AAD) occurs in up to 30% of all hospitalized patients given antibiotics. Clostridium difficile-associated diarrhea (CDAD) is both the most common and the most severe manifestation, with potential complications including colitis, ileitis, toxic megacolon, and death, noted Ms. Rovetto and associates, of Mount Sinai School of Medicine, New York.
Growing evidence suggests that probiotics such as the live, nonpathogenic yeast S. boulardii may be effective in preventing AAD and recurrent CDAD, although that organism is associated with an increased risk for fungemia, which may also lead to severe complications including death (Clin. Infect. Dis. 2005;40:1625–34).
In a study funded in part by the National Center for Complementary and Alternative Medicine of the National Institutes of Health, the investigators used data from published literature to perform a cost-effectiveness analysis of administering vs. not administering S. boulardii along with antibiotics to hospitalized patients.
The probability of CDAD was estimated to be 2% among those given the probiotic along with antibiotics vs. 5% given antibiotics alone. The increase in hospital cost per patient with CDAD was $4,129, and the probability of CDAD complications was 3%. Compared with antibiotics alone, treatment with antibiotics plus the probiotic yielded a cost saving of $81.60 per patient in addition to shortening hospital stays by about 3 days.
Patients older than 65 and those with hospital stays longer than 2 weeks stand to benefit the most. The analysis revealed that even if the protective effect of S. boulardii was halved, it would remain the preferred strategy. In fact, the only way the probiotic's benefit would be offset is if the incidence of fungemia exceeded 2 per 100 patients, “which seems highly unlikely,” they remarked.
But since the rate and potential severity of S. boulardii-associated fungemia is still not clearly defined, “We believe further studies are needed to confirm safety and effectiveness, especially in elderly and other high-risk populations” before issuing any recommendations, coauthor Dr. Henry Sacks said at the meeting sponsored by the American Society for Microbiology.
WASHINGTON — In hospitalized patients taking antibiotics, coadministration of the probiotic Saccharomyces boulardii can reduce costs, shorten hospital stays, and may save lives, Allyson L. Rovetto and her associates reported in a poster at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Antibiotic-associated diarrhea (AAD) occurs in up to 30% of all hospitalized patients given antibiotics. Clostridium difficile-associated diarrhea (CDAD) is both the most common and the most severe manifestation, with potential complications including colitis, ileitis, toxic megacolon, and death, noted Ms. Rovetto and associates, of Mount Sinai School of Medicine, New York.
Growing evidence suggests that probiotics such as the live, nonpathogenic yeast S. boulardii may be effective in preventing AAD and recurrent CDAD, although that organism is associated with an increased risk for fungemia, which may also lead to severe complications including death (Clin. Infect. Dis. 2005;40:1625–34).
In a study funded in part by the National Center for Complementary and Alternative Medicine of the National Institutes of Health, the investigators used data from published literature to perform a cost-effectiveness analysis of administering vs. not administering S. boulardii along with antibiotics to hospitalized patients.
The probability of CDAD was estimated to be 2% among those given the probiotic along with antibiotics vs. 5% given antibiotics alone. The increase in hospital cost per patient with CDAD was $4,129, and the probability of CDAD complications was 3%. Compared with antibiotics alone, treatment with antibiotics plus the probiotic yielded a cost saving of $81.60 per patient in addition to shortening hospital stays by about 3 days.
Patients older than 65 and those with hospital stays longer than 2 weeks stand to benefit the most. The analysis revealed that even if the protective effect of S. boulardii was halved, it would remain the preferred strategy. In fact, the only way the probiotic's benefit would be offset is if the incidence of fungemia exceeded 2 per 100 patients, “which seems highly unlikely,” they remarked.
But since the rate and potential severity of S. boulardii-associated fungemia is still not clearly defined, “We believe further studies are needed to confirm safety and effectiveness, especially in elderly and other high-risk populations” before issuing any recommendations, coauthor Dr. Henry Sacks said at the meeting sponsored by the American Society for Microbiology.