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Sökning: onr:"swepub:oai:gup.ub.gu.se/270149" > Göteborgs universitet > Microbial Preparati...

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FältnamnIndikatorerMetadata
00005344naa a2200853 4500
001oai:gup.ub.gu.se/270149
003SwePub
008240910s2018 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/2701492 URI
0247 a https://doi.org/10.1017/ice.2018.842 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Johnston, B. C.4 aut
2451 0a Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants
264 c 2018-04-26
264 1b Cambridge University Press (CUP),c 2018
520 a OBJECTIVE. To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children. DESIGN. Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors. METHODS. We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality. RESULTS. Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25-0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23-0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11-4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is 5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89-1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89-1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness. CONCLUSIONS. Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is >= 5%.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Infektionsmedicin0 (SwePub)302092 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Infectious Medicine0 (SwePub)302092 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi0 (SwePub)303022 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Public Health, Global Health, Social Medicine and Epidemiology0 (SwePub)303022 hsv//eng
653 a antibiotic-associated diarrhea
653 a placebo-controlled trial
653 a double-blind
653 a saccharomyces-boulardii
653 a clinical-trial
653 a efficacy
653 a epidemiology
653 a appropriate
653 a guidelines
653 a diagnosis
653 a Public
653 a Environmental & Occupational Health
653 a Infectious Diseases
653 a rding dn
653 a 1986
653 a archives of internal medicine
653 a v146
653 a p95
7001 a Lytvyn, L.4 aut
7001 a Lo, C. K. F.4 aut
7001 a Allen, S. J.4 aut
7001 a Wang, D. L.4 aut
7001 a Szajewska, H.4 aut
7001 a Miller, M.4 aut
7001 a Ehrhardt, S.4 aut
7001 a Sampalis, J.4 aut
7001 a Duman, D. G.4 aut
7001 a Pozzoni, P.4 aut
7001 a Colli, A.4 aut
7001 a Lönnermark, Elisabeth,d 1965u Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine4 aut0 (Swepub:gu)xlonel
7001 a Selinger, C. P.4 aut
7001 a Wong, S.4 aut
7001 a Plummer, S.4 aut
7001 a Hickson, M.4 aut
7001 a Pancheva, R.4 aut
7001 a Hirsch, S.4 aut
7001 a Klarin, B.4 aut
7001 a Goldenberg, J. Z.4 aut
7001 a Wang, L.4 aut
7001 a Mbuagbaw, L.4 aut
7001 a Foster, G.4 aut
7001 a Maw, A.4 aut
7001 a Sadeghirad, B.4 aut
7001 a Thabane, L.4 aut
7001 a Mertz, D.4 aut
7102 a Göteborgs universitetb Institutionen för biomedicin, avdelningen för infektionssjukdomar4 org
7730 t Infection Control and Hospital Epidemiologyd : Cambridge University Press (CUP)g 39:7, s. 771-781q 39:7<771-781x 0899-823Xx 1559-6834
8564 u https://pearl.plymouth.ac.uk/bitstream/10026.1/11863/1/2018_ind_pt_metaanalysis_probiotics_InfectControlHospEpidem.pdf
8564 8u https://gup.ub.gu.se/publication/270149
8564 8u https://doi.org/10.1017/ice.2018.84

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