Failure of dietary oligofructose to prevent antibiotic‐associated diarrhoea

Failure of dietary oligofructose to prevent antibiotic‐associated diarrhoea Summary Background : Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ‘colonization resistance’ against pathogenic bacteria. Aim : To reduce the incidence of antibiotic‐associated diarrhoea in elderly patients. Methods : Patients over the age of 65 taking broad‐spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results : No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups (n = 435). Oligofructose increased bifidobacterial concentrations (P < 0.001, 95% CI: 0.69–1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile‐positive and were more likely to be taking a cephalosporin (P = 0.006), be female (P < 0.001), to have lost more weight (P < 0.001, 95% CI: 0.99–2.00) and stayed longer in hospital (P < 0.001, 95% CI: 0.10–1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile (P = 0.006). Conclusion : Oligofructose does not protect elderly patients receiving broad‐spectrum antibiotics from antibiotic‐associated diarrhoea whether caused by C. difficile or not. Oligofructose was well‐tolerated and increased faecal bifidobacterial concentrations. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Alimentary Pharmacology & Therapeutics Wiley

Failure of dietary oligofructose to prevent antibiotic‐associated diarrhoea

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Publisher
Wiley
Copyright
Copyright © 2005 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0269-2813
eISSN
1365-2036
DOI
10.1111/j.1365-2036.2005.02304.x
pmid
15709999
Publisher site
See Article on Publisher Site

Abstract

Summary Background : Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ‘colonization resistance’ against pathogenic bacteria. Aim : To reduce the incidence of antibiotic‐associated diarrhoea in elderly patients. Methods : Patients over the age of 65 taking broad‐spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results : No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups (n = 435). Oligofructose increased bifidobacterial concentrations (P < 0.001, 95% CI: 0.69–1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile‐positive and were more likely to be taking a cephalosporin (P = 0.006), be female (P < 0.001), to have lost more weight (P < 0.001, 95% CI: 0.99–2.00) and stayed longer in hospital (P < 0.001, 95% CI: 0.10–1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile (P = 0.006). Conclusion : Oligofructose does not protect elderly patients receiving broad‐spectrum antibiotics from antibiotic‐associated diarrhoea whether caused by C. difficile or not. Oligofructose was well‐tolerated and increased faecal bifidobacterial concentrations.

Journal

Alimentary Pharmacology & TherapeuticsWiley

Published: Feb 1, 2005

References

  • The use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease
    Lewis, Lewis; Freedman, Freedman
  • Disposition kinetics of Saccharomyces boulardii in man and rat
    Blehaut, Blehaut; Massot, Massot; Elmer, Elmer; Levey, Levey
  • Selective stimulation of bifidobacteria in the human colon by oligofructose and inulin
    Gibson, Gibson; Beatty, Beatty; Wang, Wang; Cummings, Cummings
  • An elective and selective isolation medium for Bifidobacterium spp
    Beerens, Beerens
  • A study of fructo‐oligosaccharides in the prevention of travellers diarrhoea
    Cummings, Cummings; Christie, Christie; Cole, Cole

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