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August 15, 2012

Probiotics for Antibiotic-Associated Diarrhea

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Beth Israel Deaconess Medical Center, Boston, Massachusetts (Dr Videlock; videlock@gmail.com); and Southern Nevada Veterans Administration Healthcare System, Las Vegas (Dr Cremonini).

JAMA. 2012;308(7):665-666. doi:10.1001/jama.2012.8735

To the Editor: The systematic review and meta-analysis by Dr Hempel and colleagues reported the efficacy of probiotics for the prevention and treatment of antibiotic-associated diarrhea (AAD).1 We wish to comment on potential limitations of the analysis.

First, the inclusion criteria seem too broad. The review included any study in which probiotics were administered to patients receiving antibiotics. The review was part of a project on the safety of probiotic use, and some studies had debatable relevance to AAD. In one trial, for instance, probiotics were not administered until day 14 of antibiotic therapy.2