Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea

source extracted confidence: high 2026-04-09
#adult #anti-bacterial-agents #child #child-preschool #diarrhea

Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea

Szajewska et al., 2015 | Aliment Pharmacol Ther | Meta Analysis

Citation

Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015-Oct;42(7):793-801. doi:10.1111/apt.13344

Abstract

BACKGROUND: Antibiotic-associated diarrhoea is a common complication of antibiotic use, but it can be prevented with administration of probiotics. AIM: To update our 2005 meta-analysis on the effectiveness of Saccharomyces boulardii in preventing antibiotic-associated diarrhoea in children and adults. METHODS: The Cochrane Library, MEDLINE, and EMBASE databases were searched up until May 2015, with no language restrictions, for randomised controlled trials; additional references were obtained from reviewed articles. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: Twenty-one randomised controlled trials (4780 participants), among which 16 were new trials, met the inclusion criteria for this updated systematic review. Administration of S. boulardii compared with placebo or no treatment reduced the risk of antibiotic-associated diarrhoea (as defined by the study investigators) in patients treated with antibiotics from 18.7% to 8.5% (risk ratio, RR: 0.47; 95% CI: 0.38-0.57, number needed to treat, NNT: 10; 95% CI: 9-13). In children, S. boulardii reduced the risk from 20.9% to 8.8% (6 randomised controlled trials, n=1653, RR: 0.43, 95% CI: 0.3-0.6); in adults, from 17.4% to 8.2% (15 randomised controlled trials, n=3114, RR: 0.49, 95% CI: 0.38-0.63). Moreover, S. boulardii reduced the risk of Clostridium difficile-associated diarrhoea; however, this reduction was significant only in children (2 randomised controlled trials, n = 579, RR: 0.25; 95% CI: 0.08-0.73) and not in adults (9 randomised controlled trials, n = 1441, RR: 0.8, 95% CI: 0.47-1.34). CONCLUSIONS: This meta-analysis confirms that S. boulardii is effective in reducing the risk of antibiotic-associated diarrhoea in children and adults.

Key Findings

Twenty-one randomised controlled trials (4780 participants), among which 16 were new trials, met the inclusion criteria for this updated systematic review. Administration of S. boulardii compared with placebo or no treatment reduced the risk of antibiotic-associated diarrhoea (as defined by the study investigators) in patients treated with antibiotics from 18.7% to 8.5% (risk ratio, RR: 0.47; 95% CI: 0.38-0.57, number needed to treat, NNT: 10; 95% CI: 9-13). In children, S. boulardii reduced the

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1653
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adult
  • Anti-Bacterial Agents
  • Child
  • Child, Preschool
  • Diarrhea
  • Humans
  • Probiotics
  • Randomized Controlled Trials as Topic
  • Saccharomyces

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: saccharomyces-boulardii-diarrhea

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09