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August 15, 2012

Probiotics for Antibiotic-Associated Diarrhea—Reply

Author Affiliations

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

Author Affiliations: Southern California Evidence-based Practice Center, RAND Health, Santa Monica (Dr Hempel; Susanne_hempel@rand.org); RAND Corp, Santa Monica, California (Dr Miles); and West Los Angeles VA Medical Center, Los Angeles, California (Dr Shekelle).

JAMA. 2012;308(7):665-666. doi:10.1001/jama.2012.8738

In Reply: The objective of our review was to broadly evaluate the available evidence on probiotic interventions for the prevention or treatment of AAD. We presented sensitivity analyses, including results for studies explicitly aiming to prevent or treat AAD, which excluded wider applications, and results were virtually identical (relative risk, 0.58 [95% CI, 0.50-0.68] vs relative risk, 0.58 [95% CI, 0.49-0.68]).

Intention-to-treat analyses provide a conservative estimate of treatment effects. Studies were included in the meta-analysis if the number of participants randomized to each treatment group and the number of participants with diarrhea in each group were reported, independent of the analytic approach applied in individual studies.