Perils and pitfalls of probiotic quasi-experimental studies for primary prevention of Clostridioides difficile infection: A review of the evidence, American Journal of Infection Control

Quasi-experimental studies (QES) are valuable when RCTs are not feasible. • We review QES of probiotics given to high-risk patients to prevent CDI. • Probiotics were given either hospital-wide or only at a ward-level. • 50%-60% of probiotic studies found significantly reduced CDI rates. Primary prevention of Clostridioides (Clostridium) difficile infections (CDI) is an important but challenging infection control goal for hospitals and health care facilities. Enhanced infection control protocols have reduced CDI rates, but the problem persists and administration of probiotics to patients at risk could be very useful if shown to be safe and effective. Randomized controlled trials are largely impractical for primary prevention CDI trials due to large required study sizes and quasi-experimental studies are becoming more frequent as a method to assess this problem. Our goal is to review the published quasi-experimental studies adding probiotics to their infec tion control protocols to reduce CDI and determine the strengths and limitations for this type of study design. The literature was searched using PubMed, Google Scholar, Medline and Cochrane Databases and gastrointestinal meeting abstracts from January 2000 to January 2020 for quasi-experimental int ervention studies testing various probiotics for the primary prevention of CDI. We found 28 studies with 7 different types of probiotics (10 studies implementing a hospital-wide intervention, 6 studies targeting 1-3 wards, a...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news