Friday, July 25, 2014

Yogurt and C.difficile Infections in the Hospital

Here is an intriguing report in The Hospitalist on encouraging the consumption of yogurt by hospitalized patients receiving antibiotics. The health system performing this intervention reported a significant decrease in the rate of C.difficile associate diarrhea.

I have multiple reasons to be skeptical. First, I cannot find this report cited in any peer reviewed, medical journal. How can one be sure that introduction of a 'yogurt diet' was causally related to a change in C.difficile rates? What about other important factors such as changes in antibiotic stewardship, hand hygiene practices, length of stay, changes in room disinfection? Too many unanswered variables and the study design was not rigorous.

Also, the largest, most recent probiotic trial failed to show benefit on preventing C.difficile associate diarrhea. 

Yogurt will likely not impact  C.difficile in acute care settings.