Saccharomyces boulardii in the treatment and prevention of antibiotic-associated diarrhea

Background: Antibiotic-associated diarrhea (AAD) is the most frequent side effect of antibiotic therapy. Clinical signs and symptoms comprise mild and self- limiting courses of diarrhea as well as life threaten- ing courses like pseudomembranous colitis or toxic megacolon. Therapy is symptomatic, antidiarrheal drugs like Saccharomyces boulardii are the therapy of choice. Method: Available studies on S. boulardii in the prevention of AAD are presented as a review. Results: In 14 out of 17 studies including 4,627 patients the administration of S. boulardii achieved a protective effect between 43.7% and 87.3%. A meta- analysis (5 studies, 1,076 patients) showed a significant reduction of the risk to develop an AAD from 17.2% to 6.7%, in a further meta-analysis (4 studies on eradication of H. pylori, 1.215 patients) the significant reduction was from 12.2% to 5.6%. Conclusions: There is very good evidence for the yeast S. boulardii to be effective in the prevention of AAD especially in hospitalized adults. The simultaneous administration of S. boulardii to antibiotics resulted in a significant reduction to develop AAD by more than half. © 2014 Springer Medizin. All rights reserved.