Journal Article

Absence of Efficacy Of Nonviable <i>Lactobacillus acidophilus</i> for the Prevention of Traveler's Diarrhea: A Randomized, Double-Blind, Controlled Study

Valérie Briand, Pierre Buffet, Sabine Genty, Karine Lacombe, Nadine Godineau, Jérome Salomon, Eric Vandemelbrouck, Pascal Ralaimazava, Catherine Goujon, Sophie Matheron, Arnaud Fontanet and Olivier Bouchaud

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 9, pages 1170-1175
Published in print November 2006 | ISSN: 1058-4838
Published online November 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/508178
Absence of Efficacy Of Nonviable Lactobacillus acidophilus for the Prevention of Traveler's Diarrhea: A Randomized, Double-Blind, Controlled Study

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Background. Diarrhea is the most common illness associated with international tourism. We evaluated the efficacy of a probiotic preparation of nonviable Lactobacillus acidophilus (hereafter referred to as LA) for the prevention of traveler's diarrhea.

Methods. We conducted a randomized, double-blind, controlled trial. Travelers were randomized to receive either LA or placebo twice daily from 1 day before their departure to 3 days after their return. On each day of the trip and the week following the return, travelers had to record the number and consistency of stools and their adherence to the treatment. Diarrhea was defined as ⩾3 unformed stools in a 24-h period.

Results. From January 2001 to September 2004, a total of 174 subjects were randomized to each treatment group. Half of the travelers went to West Africa, and organized tours or backpacking were the most common modes of traveling. The incidence of diarrhea did not differ between the 2 groups; it was 61.4 cases per 100 person-months in the LA group (95% confidence interval [CI], 44.1–85.5) and 43.4 cases per 100 person-months in the placebo group (95% CI, 30.0–62.9) (P = .14). Adjustment for travel duration and other variables did not reveal any difference between the 2 groups (adjusted hazard ratios comparing the LA and placebo groups were 1.43 [95% CI, 0.87–2.36] in an intent-to-treat analysis and 1.38 [95% CI, 0.79–2.39] in an efficacy analysis).

Conclusions. There was no beneficial effect of treatment with LA for the prevention of travelers' diarrhea. More studies are required to assess the efficacy of other specific probiotics (e.g., a Lactobacillus rhamnosus GG preparation) for preventing traveler's diarrhea.

Journal Article.  3305 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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