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Prophylaxis against ampicillin-associated diarrhea with a lactobacillus preparation
American Journal of Hospital Pharmacy
|June 1, 1979
Summary
Lactobacillus preparations like Lactinex may help prevent ampicillin-induced diarrhea in adults. This probiotic benefit is most significant for patients with a history of antibiotic-associated diarrhea, warranting cost-benefit consideration.
Area of Science:
- Gastroenterology
- Microbiology
- Pharmacology
Background:
- Antibiotic-associated diarrhea (AAD) is a common complication of ampicillin therapy.
- Lactobacillus preparations are probiotics that may restore gut microbiota balance.
Purpose of the Study:
- To evaluate the efficacy of a Lactobacillus preparation (Lactinex) in preventing ampicillin-associated diarrhea in adult inpatients.
- To determine if prophylactic Lactobacillus administration is cost-effective.
Main Methods:
- A double-blind, randomized study involving 98 adult inpatients receiving ampicillin.
- Patients received either Lactinex (Lactobacillus acidophilus and L. bulgaricus) or a placebo for the first five days of ampicillin therapy.
- Diarrhea cases were independently reviewed and classified by etiology.
Main Results:
- Overall diarrhea incidence was 21% in the placebo group and 8.3% in the Lactinex group (not statistically significant).
- Excluding non-antibiotic-related diarrhea, ampicillin-induced diarrhea occurred in 14% of the placebo group versus 0% in the Lactinex group (p=0.03).
Conclusions:
- Prophylactic Lactobacillus administration may be effective in preventing ampicillin-induced diarrhea.
- Prophylactic use is likely justified on a cost/benefit basis primarily for patients with a history of antibiotic-induced diarrhea.