Is co-prescribing a multi-strain probiotic the solution for treating and preventing proton pump inhibitor (PPIs) induced Clostridium difficile associated diarrhoea (CDAD) while maintaining evidence based pharmacotherapy?

Abstract

A recent study investigating faecal transplants to eliminate Clostridium difficile infections has elicited further interest regarding the pharmacobiotic potential of the human gastrointestinal microbiome. Probiotic preparations may exhibit significant potential for the treatment of CDAD. Probiotics are defined as living organisms in food and dietary supplements that, upon ingestion, can improve the health of the host beyond their inherent basic nutritional content. The human–microbial gastrointestinal tract (GIT) interface is an ecosystem that participates in a variety of important roles in human health and disease. Maintaining this ecosystem in a balanced state is a critical requisite for the control of pathogenic bacteria and the associated toxin load produced in the small and large bowel. Pharmacotherapy induced adverse metabolic conditions that ensue can disrupt the GIT homeostasis and contribute toward a dysbiotic burden that increases the risk of CDAD.