We hypothesize that the prevention of AAD could be most effective if probiotics are used that are widely distributed and accepted by the patients and are not perceived as an additional drug/tablet (low threshold for intake resulting in good compliance).
In Germany and in many other countries, several formulations of lactobacillus strains are sold as food products in supermarkets.
Therefore, these formulations are easily available and could be used in the outpatient setting and during hospital stays.
The majority of these products have a pleasant taste, and the distribution of these probiotic drinks is experienced in a very positive manner by the patients.
Only one study using a commercial product has been published[22].
This study showed a positive effect of the probiotic drink; however, the study was supported by the manufacturer and used an AAD definition that is unsuitable for use in hospitals (AAD defined as 3 or more loose stools in at least 3 consecutive days)[22].
However, in hospitals, diarrhea of one-day duration leads to the isolation of the patient.
The aim of our study was to test the efficacy of commercially available probiotic drinks (Actimel® and Yakult®) in the prevention of AAD in a decision-based manner regarding necessary isolation in a primary hospital (3 loose stools on one day) independently from the manufacturer.
A calculation of the economic advantage of antibiotic-accompanied prophylactic treatment with probiotics was performed after finalizing the study.
Data from the patients were used to identify risk factors for AAD to tailor preventive probiotic treatment to certain risk groups.