High-dose Probiotic Mix of Lactobacillus spp., Bifidobacterium spp., Bacillus coagulans, and Saccharomyces boulardii to Prevent Antibiotic-associated Diarrhea in Adults: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial (SPAADA).

IF 3.8 4区 医学 Q2 IMMUNOLOGY
Open Forum Infectious Diseases Pub Date : 2024-10-21 eCollection Date: 2024-11-01 DOI:10.1093/ofid/ofae615
Vladimir Hodzhev, Karen Dzhambazov, Nikolay Sapundziev, Milena Encheva, Spiridon Todorov, Vania Youroukova, Rumen Benchev, Rosen Nikolov, Boris Bogov, Georgi Momekov, Veselin Hadjiev
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引用次数: 0

Abstract

Background: Probiotics have been used to prevent antibiotic-associated diarrhea (AAD), but practical guidelines are sparse. This trial evaluated the efficacy and safety of a high-dose, multistrain probiotic mix (Sinquanon), specially designed for prevention of AAD in adults.

Methods: A phase IV, multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted over 5 months. Participants receiving broad-spectrum antibiotics were administered the specialized probiotic mix or placebo from the first dose of antibiotics until 14 days after the last antibiotic dose. The primary outcome measure was the incidence of AAD.

Results: In total, 564 participants were randomized (probiotic mix: 285; placebo: 279), of which 9 participants discontinued the trial early (probiotic mix: 3; placebo: 6), had no efficacy data, and were excluded from the efficacy analysis. The 555 remaining participants completed the trial and were included in the efficacy analysis (probiotic mix: 282; placebo: 273). AAD occurred less frequently in the studied probiotic mix versus placebo group (9.2% vs 25.3%, P < .001), resulting in an absolute risk reduction of 16% and a number needed to treat of 6 (95% confidence interval, 4.55-10.49). A significant improvement in the average gastrointestinal quality of life in the studied probiotic mix versus placebo group was also observed. There were no clinically relevant differences in the incidence of adverse events between the studied probiotic mix and the placebo group.

Conclusions: The specially designed high-dose, multistrain probiotic mix (Sinquanon) demonstrated to be beneficial compared with placebo in the prevention of AAD in adults who received broad-spectrum antibiotics.

Clinicaltrialsgov identifier and url: NCT05607056; https://classic.clinicaltrials.gov/ct2/show/NCT05607056.

预防成人抗生素相关性腹泻的高剂量乳酸杆菌、双歧杆菌、凝结芽孢杆菌和布拉氏酵母菌混合益生菌:多中心、随机、双盲、安慰剂对照试验》(SPAADA)。
背景:益生菌已被用于预防抗生素相关性腹泻(AAD),但实用指南却很少。本试验评估了专为预防成人抗生素相关性腹泻而设计的高剂量、多菌株益生菌混合物(辛宽)的有效性和安全性:这项为期 5 个月的第四阶段多中心、随机、双盲、安慰剂对照、平行组临床试验。接受广谱抗生素治疗的参试者在首次服用抗生素至最后一次服用抗生素 14 天后,服用专用益生菌混合物或安慰剂。主要结果是AAD的发生率:共有 564 人参加了随机试验(益生菌混合物:285 人;安慰剂:279 人),其中 9 人提前终止了试验(益生菌混合物:3 人;安慰剂:6 人),没有疗效数据,因此被排除在疗效分析之外。其余 555 名参与者完成了试验,并被纳入疗效分析(混合益生菌:282 人;安慰剂:273 人)。与安慰剂组相比,混合益生菌组的 AAD 发生率较低(9.2% vs 25.3%,P < .001),绝对风险降低了 16%,治疗所需人数为 6 人(95% 置信区间为 4.55-10.49)。研究还观察到,益生菌混合物组与安慰剂组相比,平均胃肠道生活质量有了明显改善。所研究的益生菌组合与安慰剂组的不良反应发生率没有临床相关性差异:结论:与安慰剂相比,专门设计的高剂量多菌株益生菌混合物(Sinquanon)对接受广谱抗生素治疗的成人预防AAD有好处:NCT05607056;https://classic.clinicaltrials.gov/ct2/show/NCT05607056。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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