Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Children and adults being treated to prevent C. difficile diarrhoea associated with antibiotics
Intervention: Probiotics (any dose or strain) ᵃ
Comparison: Placebo or no treatment
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
C. difficile‐associated diarrhoea (CDAD) | Favours intervention | Moderate |
Detection of C. difficile in stool | No statistically significant difference | Moderate |
Duration of hospital stay | No statistically significant difference | Moderate |
Any adverse event | Occurs more commonly with placebo or no treatment compared with probiotics (favours intervention) | Very Low |
Incidence antibiotic‐associated diarrhoea | Occurs more commonly with placebo or no treatment compared with probiotics (favours intervention) | Low |
Note The Cochrane review which underpins this Cochrane Clinical Answer (CCA) performed a post-hoc subgroup analysis due to heterogeneity. This suggested probiotics were effective at preventing CDAD among people with a CDAD baseline risk of >5% but not among people with a CDAD baseline risk of ≤5%. ᵃ Most of the included studies used Lactobacillus acidophilus or Saccharomyces boulardii alone or in combination; other species included L. cerevisiae, L. reuteri, and L. rhamnosus GG.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- What are the effects of probiotics for adults and children being treated with antibiotics?
- How does vancomycin compare with other antibiotics for treatment of Clostridium difficile-associated diarrhea?
- In immunocompetent people, what are the benefits and harms of fecal microbiota transplantation (FMT) from healthy donors for the treatment of recurrent Clostridium difficile infection?
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