Abstract:
OBJECTIVE:To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. DESIGN:Randomised double blind placebo controlled study. PARTICIPANTS:135 hospital patients (mean age 74) taking antibiotics. Exclusions included diarrhoea on admission, bowel pathology that could result in diarrhoea, antibiotic use in the previous four weeks, severe illness, immunosuppression, bowel surgery, artificial heart valves, and history of rheumatic heart disease or infective endocarditis. INTERVENTION:Consumption of a 100 g (97 ml) drink containing Lactobacillus casei, L bulgaricus, and Streptococcus thermophilus twice a day during a course of antibiotics and for one week after the course finished. The placebo group received a longlife sterile milkshake. MAIN OUTCOME MEASURES: PRIMARY OUTCOME:occurrence of antibiotic associated diarrhoea. Secondary outcome: presence of C difficile toxin and diarrhoea. RESULTS:7/57 (12%) of the probiotic group developed diarrhoea associated with antibiotic use compared with 19/56 (34%) in the placebo group (P=0.007). Logistic regression to control for other factors gave an odds ratio 0.25 (95% confidence interval 0.07 to 0.85) for use of the probiotic, with low albumin and sodium also increasing the risk of diarrhoea. The absolute risk reduction was 21.6% (6.6% to 36.6%), and the number needed to treat was 5 (3 to 15). No one in the probiotic group and 9/53 (17%) in the placebo group had diarrhoea caused by C difficile (P=0.001). The absolute risk reduction was 17% (7% to 27%), and the number needed to treat was 6 (4 to 14). CONCLUSION:Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhoea and C difficile associated diarrhoea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50. TRIAL REGISTRATION:National Research Register N0016106821.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Hickson M,D'Souza AL,Muthu N,Rogers TR,Want S,Rajkumar C,Bulpitt CJdoi
10.1136/bmj.39231.599815.55subject
Has Abstractpub_date
2007-07-14 00:00:00pages
80issue
7610eissn
0959-8138issn
1756-1833pii
bmj.39231.599815.55journal_volume
335pub_type
杂志文章,多中心研究,随机对照试验abstract::Aside from email and the world wide web, there are several other systems for distributing information on the Internet. Telnet is a system that allows you to log on to a remote computer from anywhere on the Internet and affords access to many useful biomedical sites on the Internet. File transfer protocol (FTP) is a me...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7020.1626
更新日期:1995-12-16 00:00:00
abstract:OBJECTIVES:To document the extent to which maternity data are collected and how they are recorded, and to identify problems that may affect their availability throughout the NHS. METHODS:Postal survey in September 1997 with structured questionnaires. SETTING:207 NHS trusts with maternity units in England. PARTICIPAN...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7210.619
更新日期:1999-09-04 00:00:00
abstract:OBJECTIVES:To compare mix of patients, scope of practice, and duration of visit in primary care physicians in Australia, New Zealand, and the United States. DESIGN:Comparison of three comparable cross sectional surveys performed in 2001-2. Physicians completed a questionnaire on patients' demographics, diagnoses, and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39203.658970.55
更新日期:2007-06-16 00:00:00
abstract:OBJECTIVE:To synthesise the views of patients and carers in decision making regarding treatment for chronic kidney disease, and to determine which factors influence those decisions. DESIGN:Systematic review of qualitative studies of decision making and choice for dialysis, transplantation, or palliative care, and them...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.c112
更新日期:2010-01-19 00:00:00
abstract::Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant scree...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g2253
更新日期:2014-05-27 00:00:00
abstract::In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, prete...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g4929
更新日期:2014-10-06 00:00:00
abstract:OBJECTIVE:To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN:10 year follow up study based on records of suicide attempters in 1980. SETTING:Poisoning treatment centre at a general hospital. SUBJECTS:974 patients aged 15...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6893.1637
更新日期:1993-06-19 00:00:00
abstract:OBJECTIVES:To examine how insurance companies assess proposals for life assurance from applicants with raised cholesterol concentrations and to determine the excess mortality rating applied. DESIGN:Survey of 49 companies underwriting term life assurance. SETTING:United Kingdom. SUBJECTS:Four fictional men aged 30 se...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6781.891
更新日期:1991-04-13 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e3086
更新日期:2012-05-15 00:00:00
abstract:OBJECTIVE:To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN:Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING:Obstetric department and neonatal department...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39405.539282.BE
更新日期:2008-01-12 00:00:00
abstract:OBJECTIVE:To study the relation between low walking speed and the risk of death in older people, both overall and with regard to the main causes of death. DESIGN:Prospective cohort study. SETTING:Dijon centre (France) of the Three-City study. PARTICIPANTS:3208 men and women aged >or=65 living in the community, recru...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4460
更新日期:2009-11-10 00:00:00
abstract::In most European countries health has been shown to be linked to social circumstances--gradients in health status have persisted for decades, despite major changes in the principal causes of death. In central and eastern Europe life expectancy has stagnated since the mid-60s, whereas in the West it has increased; but ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.308.6937.1153
更新日期:1994-04-30 00:00:00
abstract:OBJECTIVE:To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. DESIGN:Systematic review and network meta-analysis. DATA SOURCES...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3728
更新日期:2015-07-28 00:00:00
abstract:OBJECTIVES:To see whether telling peer reviewers that their signed reviews of original research papers might be posted on the BMJ's website would affect the quality of their reviews. DESIGN:Randomised controlled trial. SETTING:A large international general medical journal based in the United Kingdom. PARTICIPANTS:54...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5729
更新日期:2010-11-16 00:00:00
abstract:OBJECTIVES:To examine the influence of parental age at delivery and birth order on subsequent risk of childhood diabetes. DESIGN:Prospective population based family study. SETTING:Area formerly administered by the Oxford Regional Health Authority. PARTICIPANTS:1375 families in which one child or more had diabetes. O...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7258.420
更新日期:2000-08-12 00:00:00
abstract:OBJECTIVE:To analyse the risk of second primary cancers during long term follow up of patients with Hodgkin's disease. DESIGN:Cohort study. SETTING:The British National Lymphoma Investigation (a collaborative group of over 60 participating centres in Britain treating lymphomas). PATIENTS:2846 patients first treated ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6835.1137
更新日期:1992-05-02 00:00:00
abstract:OBJECTIVE:To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. DESIGN:Population based case-control study with data abstracted from hospital records. SETTING:Scotland. SUBJECTS:Children aged 0-14 years resident in Scotland from 1991-4 and diagno...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7126.173
更新日期:1998-01-17 00:00:00
abstract:OBJECTIVE:To assess whether a raised serum troponin T concentration would be an independent predictor of death in patients with an acute ischaemic stroke. DESIGN:Observational study. SETTING:Auckland Hospital, Auckland, New Zealand. SUBJECTS:All 181 patients with an acute ischaemic stroke admitted over nine months i...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.320.7248.1502
更新日期:2000-06-03 00:00:00
abstract::The aim of community care is to enable people with various types of disability to live in their own homes, rather than in institutions. This involves the provision of support and services at home by various agencies. After a critical report in 1986 identified problems with coordination and flexibility of community car...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.313.7061.869
更新日期:1996-10-05 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy. DESIGN:Parallel group, cluster randomised, controlled trial of an educational package on cognitive behaviour therapy. SETTING:General practices in north London. PARTICIPANTS:84 general practitioner pr...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7343.947
更新日期:2002-04-20 00:00:00
abstract:OBJECTIVE:To assess the cost effectiveness of different screening strategies for abdominal aortic aneurysm in men, from the perspective of a national health service. SETTING:Screening units at regional hospitals. PARTICIPANTS:Hypothetical cohort of 65 year old men from the general population. MAIN OUTCOME MEASURES:C...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e4276
更新日期:2012-07-05 00:00:00
abstract::Stroke is the leading cause of long term disability in developed countries and one of the top causes of mortality worldwide. The past decade has seen substantial advances in the diagnostic and treatment options available to minimize the impact of acute ischemic stroke. The key first step in stroke care is early identi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.l6983
更新日期:2020-02-13 00:00:00
abstract:OBJECTIVES:To estimate the amount spent on specific hospital care by health agencies in 1993-4 and compare it with the resources allocated to patients registered with fundholding practices for the same type of care. To investigate whether fundholding practices and health agencies pay different amounts for inpatient car...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6946.30
更新日期:1994-07-02 00:00:00
abstract::The import of the HIV or AIDS epidemic for heterosexuals in Britain is difficult to evaluate at this stage. By June 1988, only 60 cases of heterosexually acquired AIDS are known, out of 1598 reported AIDS cases. Of these, only 6 women and 4 men presumably were infected in Britain, the rest abroad. But, judging from...
journal_title:BMJ (Clinical research ed.)
pub_type: 社论
doi:10.1136/bmj.298.6671.401
更新日期:1989-02-18 00:00:00
abstract:OBJECTIVES:To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. DESIGN AND SETTING:Prospective cohort study of long term sickness absence among employees in Denmark. PARTICIPANTS:5357 employees interviewed in 2...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38731.622975.3A
更新日期:2006-02-25 00:00:00
abstract:OBJECTIVE:To investigate estimation of calorie (energy) content of meals from fast food restaurants in adults, adolescents, and school age children. DESIGN:Cross sectional study of repeated visits to fast food restaurant chains. SETTING:89 fast food restaurants in four cities in New England, United States: McDonald's...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f2907
更新日期:2013-05-23 00:00:00
abstract::The UN has reported that five multinational pharmaceutical companies would cut down HIV drug prices in the developing world. One of these drug companies is GlaxoWellcome, which has promised to reduce the price of zidovudine and lamivudine to US$2 in the poorest nations, a fifth of its price in the US. Although Peter ...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.320.7246.1357
更新日期:2000-05-20 00:00:00
abstract:OBJECTIVE:To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. DESIGN:Time trend analysis of data from the UK general practice research database (GPRD). SETTING:General practices in the United Kingdom. SUBJECTS:Children aged 12 years or younger...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7284.460
更新日期:2001-02-24 00:00:00
abstract:OBJECTIVE:To investigate the association between long term intake of dietary and supplemental calcium and death from all causes and cardiovascular disease. DESIGN:Prospective longitudinal cohort study. SETTING:Swedish mammography cohort, a population based cohort established in 1987-90. PARTICIPANTS:61 433 women (bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f228
更新日期:2013-02-12 00:00:00
abstract:OBJECTIVE:To evaluate the association between consumption of ultra-processed foods and all cause mortality. DESIGN:Prospective cohort study. SETTING:Seguimiento Universidad de Navarra (SUN) cohort of university graduates, Spain 1999-2018. PARTICIPANTS:19 899 participants (12 113 women and 7786 men) aged 20-91 years ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l1949
更新日期:2019-05-29 00:00:00