What is your opinion about using supplements of "good" bacteria (probiotics) to help someone with recurrent Clostridium difficile diarrhea/infection?

Shelley

Clostridium difficile (CD) is a bacterium found in the colons of 2-3 percent of healthy adults. In most cases, CD causes no disease. However, in certain situations, the bacteria can multiply out of control, leading to significant diarrhea and colon inflammation -- a condition that doctors sometimes refer to as pseudomembranous colitis.

CD-associated disease occurs most frequently after the patient has taken a course of broad-spectrum antibiotics. This kills many types of good bacteria found in the colon, allowing CD to increase in numbers. Other patients who may develop CD-associated disease include those in the hospital with a critical illness (infection, burns, cardiac disease, etc.) or patients in nursing homes or other institutions.

The treatment for CD-associated disease is an antibiotic drug known to be active against this particular type of bacterium. The most frequently used are metronidazole and vancomycin. Each of these drugs is very effective against CD, and a one- to two-week course generally leads to cure of the infection. However, relapses may arise from the dormant form of CD (spores), which are not affected by the antibiotics. In this situation, repeating another course of antibiotics will usually treat the infection. In rare cases, patients may have multiple relapses. Treatment for multiple relapses may include more courses of antibiotics, along with cholestyramine, a drug that binds to the toxin of CD and prevents it from causing disease.

Another therapy, called probiotic therapy, is aimed at replenishing the normal bacterial flora of the colon in hopes it will prevent overgrowth of CD. Both Lactobacilli and Saccharomyces are among the good bacteria found in probiotic supplements, which are taken orally. Research results on probiotic therapies are preliminary. However, these agents appear to be safe and are used by experts in this field who treat severe CD cases with multiple relapses. I suggest you discuss your case with your gastroenterologist and possibly get a referral to a doctor who has expertise in treating these infections.