[Outcomes of Clostridium difficile enterocolitis after administration of antibiotics along with probiotic supplement]

Clostridium difficile enterocolitis is a potentially fatal disease showing increasing incidence in hospital environment. Therapeutic approach in the management of Clostridium difficile enterocolitis is highly complex, particularly because of its tendency to relapse and reinfection. The study was aimed at investigating the factors influencing the development of Clostridium difficile enterocolitis and outcomes of enterocolitis after administration of standard antimicrobial therapy combined with probiotic supplement.

A non-comparative prospective observational study encompassed 42 patients (22 males and 20 females) diagnosed with Clostridium difficile enterocolitis and treated at the Department of Infectious Diseases in Novi Sad in the period October 2011 - April 2012.

Higher incidence of the disease was found in elderly patients (78.6% of them were over 60 years of age), after antimicrobial therapy (83.8%), after hospitalization (83.3%) and in comorbid conditions (85.7%). The clinical picture revealed predominantly mild to moderate symptoms. A good clinical response to the standard antimicrobial therapy (metronidazole, vancomycin) combined with probiotic given for 10 days was observed in all patients, and the improvement in parameters such as the number and appearance of stools, abdominal distension and pain was recorded. Statistically significant changes in laboratory parameters (leukocyte count, C-reactive protein level) were recorded on day 5 after the onset of disease. Recurrent infection after successful therapy was observed in 9.5% of the patients.

Administration of probiotic bacteria Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium longum Rosell-175 alongside the standard antimicrobial therapy in the patients with Clostridium difficile enterocolitis demonstrated positive effects on the severity or clinical picture and normalization of laboratory parameters. Recurrent infection after successful therapy was observed in only a small number of patients as compared with the literature data.