Probiotics for the Prevention of<i>Clostridium difficile</i>–Associated Diarrhea
Authors: Steven Oscherwitz
Journal: Annals of Internal Medicine (2013)

Letters7 May 2013Probiotics for the Prevention of Clostridium difficile–Associated DiarrheaSteven Oscherwitz, MDSteven Oscherwitz, MDFrom Phoenix, Arizona.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-9-201305070-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Johnston and colleagues' review (1) with great interest. Probiotics are profitable for their sellers. Their manufacturers do not emphasize the risks of these products, and they are unregulated by the U.S. Food and Drug Administration. Johnston and colleagues make no mention of antibiotic resistance issues associated with these agents, nor do they mention cases in which probiotics have been linked to fungemia and bacterial sepsis.Probiotic organisms can easily enter the bloodstream from the bowel in compromised patients (2). I have treated 4 cases of septic shock with Saccharomyces strains (from pills) and Lactobacillus strains ...References1. Johnston BC, Ma SS, Goldenberg JZ, Thorlund K, Vandvik PO, Loeb M, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Ann Intern Med. 2012;157:878-88. [PMID: 23362517] LinkGoogle Scholar2. Beebe JL, Koneman EW, et al. Recovery of uncommon bacteria from blood: association with neoplastic disease. Clin Microbiol Rev. 1995;8:336-56. [PMID: 7553569] CrossrefMedlineGoogle Scholar3. Mater DD, Langella P, Corthier G, Flores MJ, et al. A probiotic Lactobacillus strain can acquire vancomycin resistance during digestive transit in mice. J Mol Microbiol Biotechnol. 2008;14:123-7. [PMID: 17957119] CrossrefMedlineGoogle Scholar4. Bastyr Center for Natural Health. Dispensaries. FAQs. Accessed at www.bastyrcenter.org/content/category/7/120/114/ on 2 April 2013. Google Scholar5. Mayo Clinic. Acidophilus (Lactobacillus acidophilus). Accessed at www.mayoclinic.com/health/lactobacillus/NS_patient-acidophilus on 2 April 2013. Google Scholar Author, Article, and Disclosure InformationAuthors: Steven Oscherwitz, MDAffiliations: From Phoenix, Arizona.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoProbiotics for the Prevention of Clostridium difficile–Associated Diarrhea Bradley C. Johnston , Stephanie S.Y. Ma , Joshua Z. Goldenberg , Kristian Thorlund , Per O. Vandvik , Mark Loeb , and Gordon H. Guyatt Probiotics for the Prevention of Clostridium difficile–Associated Diarrhea Bradley C. Johnston , Joshua Z. Goldenberg , and Gordon H. Guyatt Probiotics for the Prevention of Clostridium difficile–Associated Diarrhea David Louis Keller Metrics 7 May 2013Volume 158, Issue 9Page: 706KeywordsAntibiotic resistanceColonDiarrheaLactobacillusProbioticsSafetySepsisShockTransplantationVancomycin resistance ePublished: 7 May 2013 Issue Published: 7 May 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...