{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:50:56Z","timestamp":1783457456403,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T00:00:00Z","timestamp":1437955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004166","name":"Medical University of Warsaw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antibiotic\u2010associated diarrhoea is a common complication of antibiotic use, but it can be prevented with administration of probiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To update our 2005 meta\u2010analysis on the effectiveness of\n                      <jats:italic>Saccharomyces boulardii<\/jats:italic>\n                      in preventing antibiotic\u2010associated diarrhoea in children and adults.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Cochrane Library,\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      , and\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      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 (\n                      <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content>\n                      ) guidelines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010one randomised controlled trials (4780 participants), among which 16 were new trials, met the inclusion criteria for this updated systematic review. Administration of\n                      <jats:italic>S.\u00a0boulardii<\/jats:italic>\n                      compared with placebo or no treatment reduced the risk of antibiotic\u2010associated diarrhoea (as defined by the study investigators) in patients treated with antibiotics from 18.7% to 8.5% (risk ratio,\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      : 0.47; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 0.38\u20130.57, number needed to treat,\n                      <jats:styled-content style=\"fixed-case\">NNT<\/jats:styled-content>\n                      : 10; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 9\u201313). In children,\n                      <jats:italic>S. boulardii<\/jats:italic>\n                      reduced the risk from 20.9% to 8.8% (6 randomised controlled trials, n=1653, RR: 0.43, 95% CI: 0.3\u20130.6); in adults, from 17.4% to 8.2% (15 randomised controlled trials, n=3114, RR: 0.49, 95% CI: 0.38\u20130.63). Moreover,\n                      <jats:italic>S.\u00a0boulardii<\/jats:italic>\n                      reduced the risk of\n                      <jats:italic>Clostridium difficile\u2010<\/jats:italic>\n                      associated diarrhoea; however, this reduction was significant only in children (2 randomised controlled trials,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0579,\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      : 0.25; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 0.08\u20130.73) and not in adults (9 randomised controlled trials,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01441,\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      : 0.8, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 0.47\u20131.34).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This meta\u2010analysis confirms that\n                      <jats:italic>S.\u00a0boulardii<\/jats:italic>\n                      is effective in reducing the risk of antibiotic\u2010associated diarrhoea in children and adults.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.13344","type":"journal-article","created":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T00:13:19Z","timestamp":1438042399000},"page":"793-801","source":"Crossref","is-referenced-by-count":194,"title":["Systematic review with meta\u2010analysis:\n                    <i>Saccharomyces boulardii<\/i>\n                    in the prevention of antibiotic\u2010associated diarrhoea"],"prefix":"10.1111","volume":"42","author":[{"given":"H.","family":"Szajewska","sequence":"first","affiliation":[{"name":"Department of Paediatrics The Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ko\u0142odziej","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp011603"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/47.1.43"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.5.3.361"},{"key":"e_1_2_8_5_1","first-page":"491","article-title":"Antibiotic associated diarrhea in children","volume":"46","author":"Alam S","year":"2009","journal-title":"Indian Pediatr"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00465.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2014.66"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02624.x"},{"key":"e_1_2_8_9_1","unstructured":"HigginsJPT GreenS(eds).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available at:http:\/\/www.cochrane-handbook.org."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_11_1","unstructured":"Sch\u00fcnemannH BrozekJ GuyattG OxmanA(eds).GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group 2013. Available at:http:\/\/www.guidelinedevelopment.org\/handbook."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.09.012"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02356.x"},{"key":"e_1_2_8_15_1","first-page":"2072","article-title":"Essais cliniques contr\u00f4l\u00e9s en double insu de l'ultra\u2010levure lyophilis\u00e9e: \u00e9tude multicentrique par 25\u00a0m\u00e9dicins de 388\u00a0cas","volume":"84","author":"Adam J","year":"1977","journal-title":"Gaz Med Fr"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(89)91613-2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(98)80008-X"},{"key":"e_1_2_8_18_1","first-page":"439","article-title":"Prevention of beta\u2010lactam\u2010associated diarrhea by Saccharomyces boulardii compared with placebo","volume":"90","author":"McFarland LV","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_19_1","first-page":"230","article-title":"Clinical effect of triple therapy combined with\u00a0Saccharomyces\u00a0boulardii\u00a0in the treatment of\u00a0Helicobacter pylori infection in children","volume":"16","author":"Zhao HM","year":"2014","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"e_1_2_8_20_1","first-page":"143","article-title":"Double blind clinical trial on the use of ultra\u2010levure in the prophylaxis of antibiotic induced gastro\u2010intestinal and mucocutaneous disorders","volume":"3","author":"Monteiro E","year":"1981","journal-title":"Acta Med Port"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0034-98872008000800004"},{"key":"e_1_2_8_22_1","first-page":"PI19","article-title":"Prophylactic Saccharomyces boulardii in the prevention of antibiotic\u2010associated diarrhea","volume":"12","author":"Can M","year":"2006","journal-title":"Med Sci Monit"},{"key":"e_1_2_8_23_1","first-page":"70","article-title":"Saccharomyces boulardii in the prevention of antibiotic associated diarrhea in children: a randomized controlled trial","volume":"14","author":"Casem RAO","year":"2013","journal-title":"Pediatr Infect Dis Soc Philipp J"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/50.4.234"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.56"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3920\/BM2013.0008"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.5897\/AJPP12.400"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-5378.2007.00516.x"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.07063.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200512000-00015"},{"key":"e_1_2_8_31_1","first-page":"1","article-title":"A lyophilized form of Saccharomyces boulardii enhances the Helicobacter pylori eradication rates of omeprazole\u2010triple therapy in patients with peptic ulcer disease or functional dyspepsia","volume":"8","author":"Kyriakos N","year":"2013","journal-title":"Hospital Chronicles"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-5378.2010.00751.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2015.18.1.17"},{"issue":"1","key":"e_1_2_8_34_1","first-page":"S99","article-title":"The efficacy and safety of adding the probiotic Saccharomyces boulardii to standard triple therapy for eradication of H. pylori: a randomized controlled trial","volume":"6","author":"Zojaji H","year":"2013","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i18.2202"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X11428502"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.67.1.302-307.1999"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.69.4.2762-2765.2001"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M605200200"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1006\/mpat.2002.0495"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90280-P"},{"key":"e_1_2_8_42_1","first-page":"CD006095","article-title":"Probiotics for the prevention of Clostridium difficile\u2010associated diarrhea in adults and children","volume":"5","author":"Goldenberg JZ","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.3507"},{"key":"e_1_2_8_44_1","first-page":"e56","article-title":"Probiotics for the prevention of antibiotic\u2010associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta\u2010analysis","volume":"7","author":"Pattani R","year":"2013","journal-title":"Open Med"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.3920\/BM2014.0034"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04874.x"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.092129"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28759"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.11"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13344","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T07:01:15Z","timestamp":1694415675000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,27]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1111\/apt.13344"],"URL":"https:\/\/doi.org\/10.1111\/apt.13344","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.725678869.793515857","asserted-by":"object"}]},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,27]]}}}