Probiotics for the Prevention of Antibiotics Associated Diarrhoea and Clostridium Difficile Associated Diarrhoea

Probiotics for the Prevention of Antibiotics Associated Diarrhoea and Clostridium Difficile Associated Diarrhoea

The investigators aim to investigate whether the routine use of the probiotic formulation VSL#3 co-prescribed with antibiotics reduces the incidence of both Antibiotic associated diarrhoea and Clostridium Difficile associated diarrhoea.

The investigators aim to find out whether VSL#3 can prevent Antibiotic associated diarrhoea and Clostridium Difficile associated diarrhoea when VSL#3 is giving during a course of systemic antibiotics. Patients will be randomized in a 1:1 proportion to receive either one sachet of VSL#3 or a similar looking placebo twice a day. This will be given for the length of the antibiotic course and another week thereafter. Follow-up will last until 28 days after the last antibiotic dose. Patient restarted on antibiotics during follow-up will be restarted on the trial medication and the 28 day follow-up will be recommenced.

This trial has 2 co-primary outcome measures.

Inclusion Criteria:

• Adults aged 18 or older
• Hospital inpatients
• On systemic antibiotics for an infection
• Antibiotics started within last 48 hours

Exclusion Criteria:

• Diarrhoea at screening
• Unable to take enteral meds
• Patients on intensive care units
• Severe Immunosuppression (neutropenia, AIDS, congenital immunoparesis, chemotherapy)
• Risk of endocarditis (Artificial heart valves, history of rheumatic heart disease or infective endocarditis)
• Regular consumption of probiotics until 1 week prior to admission
• Acute severe pancreatitis Persistent vomiting (two days or more)