Effectiveness and safety of probiotics in the treatment of clostridium difficile infection in european countries: a systematic review

Background: Although the incidence of Clostridium difficile infection (CDI) has significantly reduced, people still contract this infection and it remains a burden to the health care system. However, medical interventions such as probiotics, and faecal transplants are still being explored and evaluated in a bid to ameliorate this condition. Aim: The aim of this study is to establish quality evidence on the effectiveness and safety of probiotics in the treatment of C. difficile infection in European Countries. Method: A systematic search for articles and journal literature published between 2010 and 2015, relevant to this research study was conducted on: COCHRANE LIBRARY, DISCOVER, EMBASE, GOOGLE SCHOLAR, MEDLINE, MESH, PUBMED, SCIENCE CITATION INDEX and SCIENCE DIRECT from June, 2015 – August, 2015. Included studies were randomised control trials and case studies assessing probiotics and Faecal Microbial Transplant (F.M.T.) in the prevention and treatment of CDI Result: 7 studies were reviewed. 4 examined the effectiveness of faecal microbial transplant (F.M.T.) in the treatment of CDI In a population experiencing recurrence while 3 assessed the effectiveness of one or more probiotic strains in the treatment/ prevention of CDI All studies demonstrated that either of these treatment options is effective in the management of CDI however, 2 studies that showed that specific probiotics such as Sacchromyces bourladii or a multi-strain probiotic is not effective in the treatment of Clostridium difficile associated diarrhoea (C.D.A.D.). All reviewed studies suggested that the adverse effects associated with probiotics and F.M.T are mild in severity. Conclusion: Probiotics including F.M.T, appear: to be effective in the treatment and prevention of CDI, particularly after a short regimen of antibiotic/ bowel lavage. There are limited clinical trials on these treatment measures perhaps as a result of the plunge in the incidence of CDI However, more studies are required to boost the available evidence.