Background: Over 70% of patients are prescribed antibiotics during their intensive care\n(ICU) admission. The gut microbiome is dramatically altered early in an ICU stay, increasing the risk\nfor antibiotic associated diarrhea (AAD) and Clostridium difficile infections (CDI). Evidence suggests\nthat some probiotics are effective in the primary prevention of AAD and CDI. Aim: To demonstrate\nsafety and feasibility of a probiotic drink in ICU patients. Methods: ICU patients initiated on\nantibiotics were recruited, and matched with contemporary controls. Study patients received two\nbottles daily of a drink containing 10 billion Lactobacillus casei which was bolused via feeding tube.\nTolerance to probiotics and enteral nutrition, development of adverse events, and incidence of AAD\nwas recorded. CDI rates were followed for 30 days post antibiotic treatment. Results: Thirty-two\npatients participated in the trial. There were no serious adverse events in the probiotic group,\ncompared to three in the control group. AAD was documented in 12.5% of the probiotic group and\n31.3% in the control group. One patient in the probiotic group developed CDI compared to three in\nthe control group. Discussion: A probiotic containing drink can safely be delivered via feeding tube\nand should be considered as a preventative measure for AAD and CDI in ICU.
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