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Failure of dietary oligofructose to prevent antibiotic‐associated diarrhoea
Author(s) -
Lewis S.,
Burmeister S.,
Cohen S.,
Brazier J.,
Awasthi A.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02304.x
Subject(s) - clostridium difficile , medicine , antibiotics , diarrhea , incidence (geometry) , gastroenterology , amoxicillin , antibiotic associated diarrhea , cephalosporin , feces , placebo , microbiology and biotechnology , biology , physics , alternative medicine , optics , pathology
Summary Background : Oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. High bifidobacteria concentrations are important in providing ‘colonization resistance’ against pathogenic bacteria. Aim : To reduce the incidence of antibiotic‐associated diarrhoea in elderly patients. Methods : Patients over the age of 65 taking broad‐spectrum antibiotics received either oligofructose or placebo. A baseline stool sample was cultured for Clostridium difficile and tested for C. difficile toxin. A further stool sample was analysed for C. difficile if diarrhoea developed. Results : No difference was seen in the baseline characteristics, incidence of diarrhoea, C. difficile infection or hospital stay between the two groups ( n = 435). Oligofructose increased bifidobacterial concentrations ( P < 0.001, 95% CI: 0.69–1.72). A total of 116 (27%) patients developed diarrhoea of which 49 (11%) were C. difficile ‐positive and were more likely to be taking a cephalosporin ( P = 0.006), be female ( P < 0.001), to have lost more weight ( P < 0.001, 95% CI: 0.99–2.00) and stayed longer in hospital ( P < 0.001, 95% CI: 0.10–1.40). Amoxicillin (amoxycillin) and clavulanic acid increased diarrhoea not caused by C. difficile ( P = 0.006). Conclusion : Oligofructose does not protect elderly patients receiving broad‐spectrum antibiotics from antibiotic‐associated diarrhoea whether caused by C. difficile or not. Oligofructose was well‐tolerated and increased faecal bifidobacterial concentrations.