Lactoferrin for the Prevention of Post-antibiotic Diarrhoea

Alison M Laffan,Robin Mckenzie,William B Greenough Iii,Jennifer Forti,Dawn Conklin,Richard Marcinko,Michele Bellantoni,Ruchee Shrestha

doi:10.3329/jhpn.v29i6.9889

Abstract

Antibiotic-associated diarrhoea (AAD) is a common cause of morbidity and mortality. Older individuals in long-term care facilities are particularly vulnerable due to multisystem illnesses and the prevailing conditions for nosocomial infections. Lactoferrin, an antimicrobial protein in human breastmilk, was tested to determine whether it would prevent or reduce AAD, including Clostridium difficile in tube-fed long-term care patients. Thirty patients were enrolled in a randomized double-blind study, testing eight weeks of human recombinant lactoferrin compared to placebo for the prevention of antibiotic-associated diarrhoea in long-term care patients. Fewer patients in the lactoferrin group experienced diarrhoea compared to controls (p = 0.023). Based on the findings, it is concluded that human lactoferrin may reduce post-antibiotic diarrhoea.

Highlights

Up to 25% of patients treated with broad-spectrum antibiotics experience diarrhoea (1), and this antibiotic-associated diarrhoea (AAD) can vary from mild nuisance loose or watery stools to severe diarrhoea, including colitis
Data relating to stool for 22 participants (13 control and 9 lactoferrin participants) were analyzed
Shorter times since the last antibiotic therapy were observed in the lactoferrin group (p=0.07), and these participants were more likely to be enrolled in the second phase of the study (p=0.07)

Summary

Introduction

Up to 25% of patients treated with broad-spectrum antibiotics experience diarrhoea (1), and this antibiotic-associated diarrhoea (AAD) can vary from mild nuisance loose or watery stools to severe diarrhoea, including colitis. Patients in long-term care are vulnerable, and AAD is an important cause of disability and death in this population (2). Clostridium difficile, a known aetiologic agent, explains less than half of these cases. The consequences of AAD can be severe, leading to debility due to volume depletion, enteral protein loss, and a chronic inflammatory state (3). AAD is being treated with antibiotics and may contribute to the growing problem of antibiotic-resistant pathogens (4). We employed a normal human breastmilk protein—lactoferrin—which has both anti-inflammatory and antimicrobial properties (5) and has recently been shown to reduce

Methods

Results

Conclusion