Efficacy Of A Mixture Of Probiotic Containing saccharomyces boulardii and lactobacillus in Preventing Antibiotic Associated Diarrhea In Patients Taking Triple Therapy For H Pylori Eradication

Khanal A*, Mishra AK**, Shrestha D***,Chaudhari SR**** , Basnet BK*****

Abstract


Introduction: Antibiotic Associated Diarrhea (AAD) is a common complication in patients taking antibiotics. The incidence of Antibiotic Associated Diarrhea varies according to antibiotic treatment and its course. The incidence of Antibiotic Associated Diarrhea for Amoxycillin is reported to be upto 25%and that the incidence increases further if multiple antibiotics are used. Meta-analyses reveal that especially Saccharomyces boulardii and also Lactobacillus species of the probiotics have a definite role in preventing Antibiotic Associated Diarrhea. Administering different drug regimes for eradication of Helicobacter infection is a commonplace in today’s era. These patients are administered antibiotics as part of the treatment. Therefore, we undertook this study in patients taking 14 days’ course of triple therapy including Clarithromycin, Amoxycillin and Pantoprazole to see the efficacy of a mixture of probiotics containing S. boulardii and Lactobacillus in preventing Antibiotic Associated Diarrhea.

Method: A total of 40 patients were enrolled in this single centered prospective, interventional, intention to treat clinical trial. Both peptic ulcer and non-ulcer dyspepsia patients were included in the study. Patients were randomly assigned into two groups. The treatment group comprised of 20 patients taking H. Pylori(Helicobacter Pylori) eradication triple therapy along with probiotics for 14 days; who were given the treatment on the basis of evidence of H pylori infection, either endoscopy and tissue biopsy or clinical features and positive serology for H Pylori. The control group comprised of 20 patients receiving the same triple therapy drugs for H Pylori eradication for the same duration; but not receiving the Probiotics. In this group too, indication for H pylori eradication therapy was same like in the control group.

Result: The ages of the patients in the two groups and male female ratios were comparable. The median age of patients in the treatment group was 41.95 years with SD 14.7 and it was 43.7 with SD 14.7 years in the control group. In the treatment group, only one out of twenty(5%) patient developed diarrhea on the 6th day of commencing the treatment. In the control group, a total of 5 out of 20(25%) patients developed diarrhea on various days of having started the treatment, but all developing it within a week. The median duration of development of diarrhea was 3.4 ±1.1 days. There was lower incidence of occurrence of diarrhea in the treatment group.

Conclusion: A probiotic mixture containing Saccharomyces boulardii(S. boulardii)& lactobacillus is effective in preventing Antibiotic Associated Diarrhea in patients receiving triple therapy for Helicobacter Pylori eradication.

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