The Cambridge Clostridium Difficile Study

Overview

What is Clostridium difficile?
Clostridium difficile (C.difficile) is a bacterium which can be found in low numbers in the large intestine (colon) of some healthy people (2%-5%), without causing any harm, and is unable to grow excessively due to competition from beneficial bacteria of the intestine. The bacterium can form spores which enable it to survive for long periods in the environment (on clothes, bedding, surfaces, floors, around the toilets, etc.)

What does Clostridium difficile cause?
If the number of C.difficile increases greatly in the colon of the patient, almost always because of antibiotic use, the bacterium starts producing toxins (poisons) that can cause mild to severe diarrhoea. In some cases this can lead to serious infections, such as colitis (inflammation of colon), sepsis and death. C.difficile associated with diarrhoea (CDAD) accounts for 15% to 30% of all episodes of antibiotic-associated diarrhoea (Simor 2010).

How may probiotics help in the prevention/treatment of CDAD?
Probiotics are live beneficial microorganisms from the human gut, which help to maintain protective gut microflora, reduce survival of pathogenic (‘bad’) bacteria and produce the antimicrobial substances that are harmful to bad bacteria and stimulate and support the immune system. The most common probiotic bacteria are the lactobacilli and bifidobacteria.

It has been suggested that regular supplementing of large numbers of these beneficial bacteria to patients receiving antibiotic therapy restricts the growth of C. difficile by competing for nutrients in the colon and neutralizing C. difficile toxins, which lowers risk of infections and helps maintain the balance of the gut microflora during and following antibiotic therapy.

The aim of the Cambridge Clostridium Difficile Study

This study was aimed at providing evidence that supplementing with Lab4 probiotic while taking antibiotics can prevent the incidence of antibiotic associated C.difficile diarrhoea.

How the Cambridge Clostridium Difficile Study was set up

  • 138 elderly patients requiring antibiotic therapy were divided into two equal groups.
  • One group took 25 billion Lab4 probiotics daily in conjunction with their prescribed antibiotics.
  • The other half took a dummy capsule with their prescribed antibiotics.
  • The efficacy of Lab4 in the prevention of CDAD was assessed by recording the bowel habit and faecal samples analysis.

The results

  • The patient group given Lab4 probiotic had reduced incidence of Clostridium difficile diarrhoea compared to placebo group.
  • This effect was due to the reduction in the presence of Clostridium difficile toxin in the Lab4 group.