• Amita Avadhani and Helen Miley.
• Department of Adult ICU-5G, Saint Peters University Hospital, Kendall Park New Brunswick, New Jersey 08901, USA.
• J Am Acad Nurse Pract. 2011 Jun 1; 23 (6): 269-74.

PurposeA serious complication associated with the use of most antibiotics is antibiotic-associated diarrhea (AAD). The purpose of this article is to report findings from a meta-analysis of available studies on adult hospitalized populations to evaluate efficacy of probiotics for prevention of AAD and Clostridium difficile-associated disease (CDAD).Data SourcesA comprehensive, systematic search was conducted to identify all relevant studies on probiotic efficacy for prevention of AAD and CDAD. Data synthesis was done using MAStARI software from the Joanna Briggs Institute (University of Adelaide, Australia).ConclusionsAAD affects one in five people on antibiotics. Risk factors for the development of AAD include the use of broad-spectrum antibiotics and host factors such as age, health status, hospitalization status, and exposure to nosocomial pathogens. About a third of AAD cases have CDAD. Meta-analysis showed that administration of probiotics led to a statistically significant relative risk reduction of 44% for AAD and 71% for CDAD.Implications For PracticeExtended hospital stays, readmissions, and higher hospital costs are just some of the consequences of ADD and CDAD. Strategies currently used include discontinuing or changing the inciting antibiotic, restricting high-risk antibiotics, and encouraging the use of antibiotics based on sensitivity reports. Healthcare spending, morbidity, and mortality can potentially be reduced considerably by reducing the occurrence of ADD and CDAD by administering prophylaxis with probiotics concurrently with antibiotics.©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

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