Saccharomyces Boulardii in the Prevention of Pseudomembranous Colitis

Abstract

Objective

To evaluate the efficacy of the yeast Saccharomyces boulardii in the prevention of pseudomembranous colitis (PMC).

Data Sources

A MEDLINE search (January 1966–April 2000, updated July 2001) of English-language medical literature was conducted. Key search terms included Saccharomyces boulardii, pseudomembranous colitis, antibiotic-associated diarrhea, and Clostridium difficile. Additional information was obtained from pathophysiology and medical textbooks.

Data Synthesis

S. boulardii is a nonpathogenic yeast used to treat and prevent antibiotic-associated diarrhea, including PMC, a serious, sometimes refractory complication of antibacterial drug therapy. A literature search was conducted to determine its efficacy in preventing PMC.

Conclusions

When administered in combination with standard treatments, S. boulardii does not appear to prevent the first relapse but does appear to reduce subsequent recurrences of probable PMC in patients experiencing antibiotic-associated diarrhea. It has also shown promise as monotherapy in preventing the development of antibiotic-associated diarrhea in patients not experiencing diarrhea. Further well-designed, controlled studies are needed.