EFFECTIVENESS OF PROBIOTIC IN PREVENTING ANTIBIOTIC ASSOCIATED DIARRHOEA AND/OR CLOSTRIDIUM DIFFICILE ASSOCIATED DIARRHOEA IN PATIENTS WITH SPINAL CORD INJURY: A SYSTEMATIC REVIEW

摘要

This systematic review plan to investigate the effectiveness ofprobiotic in preventing diarrhoea associated with antibiotics (AAD) and Clostridium difficile infection (CDI) in spinal cord injury (SCI) patients. CENTRAL; HTA Database; CINAHL; PsycINFO;Embase; Medline; AMED and DARE were queried from inception to 27th February 2015, with the subject heading terms "probiotics" combined with "diarrhoea", "antibiotic", "Clostridium difficile" and "spinal cord injuries". All trials assessed the effectiveness ofprobiotic and AAD or CDI in SCI-patients were sought. 150publications were identified, of which 2 papers (1 RCT and 1 case-control study) met inclusion criteria and were evaluated. Of these, 1,031 SCI patients were included (140 received intervention and 891 controls). Among studies examiningprobiotic in preventing AAD I CDI in SCI patients, one study reported the probiotic may prevent AAD (54.9% vs. 17.1%, p<0.01), two studies reported probiotic may prevent CDI. The results were considered inconclusive because of the limited number of trials conducted in the SCI population, due to the absence of sample homogeneity, thereby providing a low level of evidence for clinical practice. Further research is suggested to inform the choice, duration and dose ofprobiotic in preventing AAD I CDI in SCI patients.