Clostridioides difficile is the leading cause of infectious diarrhea (Vernaya et al., 2017). Probiotics have been proposed to provide a protective benefit against Clostridioides difficile infection (CDI). The objective of this literature review was to examine the research evidence pertaining to the use of probiotics for the prevention of CDI in individuals receiving antibiotic therapy. A systematic literature review of studies published between 2015 and 2019 was performed. Five databases were searched, which yielded 10 systematic reviews that met strict inclusion criteria. Overall, the majority of evidence indicated that probiotics versus no treatment, placebo, or usual care have the potential to reduce CDIs in patients on antibiotic therapy by 50% or greater. There was no increased risk of adverse events among those taking probiotics. Benefit is greater when the background risk of CDIs was over 5%. The optimal probiotic dose, duration, species, and formulation is not known, although multispecies or Lactobacillus probiotics may be more effective in addition to taking probiotics within one to two days of starting antibiotics. These findings are limited to patients that are not immune compromised, pregnant, elderly, critically ill, have not had recent surgery, and do not have prosthetic heart valves. Overall, due to the magnitude of the effect of probiotics and their favorable safety profile, providers should consider including a shared decision-making conversation with their patients taking antibiotics regarding their personal risk versus benefit option to take probiotics concurrently.


Rhonda Cornell

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing



Rights Statement

In Copyright