Cochrane · systematic review · CD006095
Probiotics for the prevention of Clostridium difficile‐associated diarrhea in adults and children
Goldenberg, JZ, Yap, C, Lytvyn, L, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
10
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 10%Low 3 · 30%Moderate 6 · 60%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyProbiotics compared to control for preventing C. difficile associated diarrhea
Population: preventing C. difficile associated diarrhea
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence CDAD: complete case Probiotics vs control | RR 0.4 [0.3, 0.52] | 31 studies · 8672 participants | Moderate Downgraded: indirectness |
CDAD (baseline risk 0‐2%) Probiotics vs control | RR 0.77 [0.45, 1.32] | 15 studies · 5845 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
CDAD (baseline risk 3‐5%) Probiotics vs control | RR 0.53 [0.16, 1.77] | 3 studies · 373 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
CDAD (baseline risk >5%) Probiotics vs control | RR 0.3 [0.21, 0.42] | 13 studies · 2454 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Incidence of C. difficile infection: complete case Probiotics vs control | RR 0.86 [0.67, 1.1] | 15 studies · 1214 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Adverse Events: complete case Probiotics vs control | RR 0.83 [0.71, 0.97] | 32 studies · 8305 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Incidence AAD: complete case Probiotics vs control | RR 0.58 [0.48, 0.7] | 33 studies · 8870 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
AAD (Adults) Probiotics vs control | RR 0.62 [0.51, 0.76] | 23 studies · 7036 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
AAD (Children) Probiotics vs control | RR 0.38 [0.29, 0.49] | 6 studies · 1141 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Length of Hospital Stay: complete case Probiotics vs control | no estimate extracted | 4 studies · 3484 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Probiotics for the prevention of Clostridium difficile associated diarrhea
Population: adults and children exposed to antibiotics
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clostridium difficile associated diarrhea diarrhea as defined by authors + cytotoxin and culture or both | RR 0.36 [0.26, 0.51] | 23 studies · 4213 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Adverse events as defined or described by authors | RR 0.8 [0.68, 0.95] | 26 studies · 3964 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Clostridium difficile infection cytotoxin and/or culture | RR 0.89 [0.64, 1.24] | 13 studies · 961 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Length of hospital stay days spent in hospital | no estimate extracted | 3 studies · 422 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Antibiotic associated diarrhea as defined by study authors | RR 0.6 [0.49, 0.72] | 25 studies · 4097 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |