Prevention of β‐Lactam‐Associated Diarrhea by Saccharomyces boulardii Compared with Placebo

Lynne V. McFarland, Christina M. Surawicz, Richard N. Greenberg, Gary W. Elmer, Kris A. Moyer, Sally A. Meicher, Karen E. Bowen, Jenny L. Cox

Research output: Contribution to journalArticlepeer-review

336 Scopus citations


Objectives: To determine the safety and efficacy of a new preventive agent for antibiotic‐associated diarrhea (AAD) in patients receiving at least one β‐lactam antibiotic. Methods: A double‐blinded, placebo‐controlled, parallel group study was performed in a high‐risk group of hospitalized patients receiving a new prescription for a β‐lactam antibiotic and having no acute diarrhea on enrollment. Lyophilized Saccharomyces bonlardii or placebo (1 g/day) was given within 72 h of the start of the antibiotic(s) and continued until 3 days after the antibiotic was discontinued, after which the patients were followed for 7 wk. Results: Of the 193 eligible patients, significantly fewer, 7/97 (7.2%), patients receiving S. boulardii developed AAD compared with 14/96 (14.6%) on placebo (p= 0.02). The efficacy of S. boulardii for the prevention of AAD was 51%. Using a multivariate model to adjust for two independent risk factors for AAD (age and days of cephalosporin use), the adjusted relative risk was significantly protective for S. boulardii (RR = 0.29, 95% C1 = 0.08, 0.98). Conclusion: The prophylactic use of S. boulardii given with a β‐lactum antibiotic resulted in a significant reduction of AAD with no serious adverse reactions.

Original languageEnglish
Pages (from-to)439-448
Number of pages10
JournalAmerican Journal of Gastroenterology
Issue number3
StatePublished - Mar 1995

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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