Effect of lactobacillus casei shirota in preventing antibiotic associated diarrhoea including clostridium difficile infection in patients with spinal cord injuries: a multicentre randomised, double-blinded, placebo-controlled trial

Abstract

Rationale: Antibiotic associated diarrhoea (AAD) and Clostridium difficile infection (CDI) are of major clinical concern in spinal cord injury (SCI) rehabilitation. Neurogenic bladder dysfunction as a result of SCI often leads to enhanced risk of urinary tract infections.1 Use of invasive devices such as urinary catheters further increases the need for antibiotics and the risks of AAD and CDI.2 A previous open-labelled study found that SCI patient taking a probiotic containing at least 6.5x109 live Lactobacillus casei Shirota (LcS) could prevent AAD.3 In order to confirm this effects and fully demonstrate the extent of LcS effectiveness in preventing AAD/CDI, a double-blinded, placebo-controlled study is indicated.