Introduction Clostridium difficile infection is an important hospital acquired infection causing significant healthcare burden. Once patients have had C diff diarrhoea, recurrence rates are high with 44.8% of patients having a relapse of their disease. Lactobacillus Casei is a probiotic that has been shown to reduce rates of antibiotic-associated diarrhoea in elderly patients. There have been no studies analysing the use of probiotics in patients who have had established C.diff infection.

Methods The study was a single site, retrospective, case-control study of patients who have had C.diff infection and treated with either antibiotics and probiotics or antibiotics alone. Potential study participants were identified from the microbiology database. Criteria for inclusion in the study were adult patients (aged > 18 at time of infection), presence of diarrhoea (defined as ≥ 3 non-formed stool in 24 hours), positive stool C. diff toxin A or B and positive C. Diff antigen.

Results 66 patients were included for analysis in this study, 31 who had probiotics and 35 who had no-probiotics. The median age of the patients was 78 and 33.3% were male. The number of patients who had a further hospital admission for diarrhoea in the probiotic cohort was 6 (19.4%), compared to 13 in the non-probiotic cohort (35.1%) (p = 0.09). Rates of recurrent C.diff infection were significantly lower, 31.4% vs 6.5% (p = 0.024).

Conclusion Patients who have had a c.diff infection often have early re-admissions to hospitals as a result of further episodes of diarrhoea or c.diff recurrence. These admissions are associated with significant morbidity and mortality and cost to the health service. This study suggests that the widely available probiotic strain lactobacillus casei appears able to reduce rates of c.diff recurrence rates though further prospective studies are required.

Disclosure of Interest None Declared.