Transcript Results (1)

Lactobacilli and bifi dobacteria in the prevention of antibiotic-associated dia
rrhoea and Clostridium diffi cile diarrhoea in older inpatients (PLACIDE): a r
andomised, double-blind, placebo-controlled, multicentre trial
Stephen J Allen, Kathie Wareham, Duolao Wang, Caroline Bradley, Hayley Hutchings, Wyn
Harris, Anjan Dhar, Helga Brown, Alwyn Foden, Michael B Gravenor, Dietrich Mack
Lancet 2013; 382: 1249–57
October 12, 2013
2013-11-04 월요저널
R1. 박은지 / Pf. 이창균
Introduction
 Antibiotic-associated diarrhoea (AAD)
 C difficile diarrhoea (CDD)
 ≥65 years
 Broad-spectrum antibiotics
 Cephalosporins, fluoroquinolones, macrolides, tetracycline (2–20%)
 Ampicillin (5–10%)
 Self-limiting illness (15–39%)
 Pseudomembranous colitis, toxic megacolon
 Microbial preparations have been assessed in the prevention of AAD
 (BUT) Insufficient data !!
Methods (1)
Patients
- Multicentre, randomised, double-blind, placebo-controlled
- Age ≥65 years
-Exposed to one or more oral or parenteral antibiotics
Exclusion criteria
Existing diarrhoea
immunocompromised sufficiently
prosthetic heart valve,
CDD in the previous 3 months
IBD
acute pancreatitis
mesenteric vessel abnormality,
previous adverse reaction to microbial preparations
Total 17420
2 Groups
Microbial preparation group 1493 → 1470
Placebo group 1488 → 1471
Results (1)
Table 1.
Characteristics of the patients
*Duration (ADM~Starting anti)
P=0.35
*Indication for anti
*Non-anti drug combination
Total N=362
Results (2)
Table 2.
Antibiotic therapy by class and
treatment group
Results (2)
Table 2.
Antibiotic therapy by class and
treatment group
Results (3)
Table 3.
morbidity
In the fi rst 3 weeks
AAD
(including CDD)
CDD
*ADD duration &
severity
P = 0.71
0.99%
P = 0.35
Conclusion
 No evidence that a multistrain preparation of lactobacilli and
bifidobacteria was effective in prevention of AAD or CDD !!
Thank you !