The effectiveness of probiotics in reducing the incidence of Clostridium difficile associated diarrhea in elderly patients: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE The objective of this review is to assess the effectiveness of probiotics in reducing the incidence of Clostridium difficile-associated diarrhea in elderly patients (60 years and older) who are residents of acute- and post-acute care facilities. INCLUSION CRITERIA Types of participants This review will consider studies that include participants aged 60 years and older who are residents of acute- and post-acute care facilities and are undergoing or planning to undergo antibiotic treatment. Studies that include participants undergoing treatment for Clostridium difficile associated diarrhea will be excluded. Types of intervention(s) This review will consider studies that evaluate the effectiveness of probiotics for prevention of Clostridium difficile associated diarrhea in elderly patients in acute- and post-acute care settings compared to usual care. Any brand or strength of a probiotic product will be considered for the review. The review will also include studies examining various forms of probiotics, such as yogurt, buttermilk, combination products or capsules. Types of outcomes This review will consider studies that include the following outcome measures: incidence or relapse of Clostridium difficile associated diarrhea. Cases of Clostridium difficile associated diarrhea will be defined by presence of diarrhea and verified by positive results for stool enzyme immunoassay for toxins A and B. Absence of diarrhea verified by negative results for stool enzyme immunoassay for toxins A and B.