Hospitals in the south of England are giving patients commercially available probiotic yoghurt in trials to help prevent the spread of superbugs on wards.

Both the Royal Sussex County Hospital in Brighton and the Princess Royal in Haywards Heath are providing patients with free pots of probiotic yoghurt drinks in an effort to prevent them developing certain infections during their stay.

The trial is specifically aimed at stopping the continued rise in cases of Clostridium difficile infections.

Clostridum difficile (commonly referred to as C. diff) is a bacterium that damages the intestinal lining and causes diarrhoea. In the worst cases it can lead to severe illness with ulceration and bleeding from the colon (colitis) and even perforation of the intestine leading to peritonitis.

C. diff infection most commonly develops in people who have undergone prolonged therapy with broad spectrum antiobiotics; the drugs killing off the 'friendly bacteria' in the gut which would normally protect against C. diff infection. Those most at risk are the elderly with serious underlying medical conditions.

In a hospital setting C. diff can spread rapidly through patient to patient contact, medical staff, and contamination if strict hygiene practices are not implemented.

Mandatory reporting of C. diff infection in the UK is now in place and figures show rather startling increases in the number of cases. In just one year from 2003 to 2004 the number of cases rose from 28,000 to 44,488. This has prompted medical authorities to seek new methods to control to the problem.

The interest in probiotic bacteria and products that are designed to increase their numbers in the gut has rocketed over the past decade. More than two million Britons now buy probiotic products which include yoghurt, drinks, and capsules/tablets.

The interest in the medical research community has been just as great. Searching the PubMed database of published medical research reveals thousands of studies have been conducted on probiotic bacteria and products.

Whether probiotics can help in the treatment of C. diff and antiobiotic associated diarrhoea has received a lot of attention and there have been some promising results. It is thought that probiotics can help to repopulate the gut with beneficial bacteria after antibiotic therapy therefore preventing (or even treating) C. diff infection. Some studies however have found only marginal benefits and the use of different probitoc bacteria strains can confuse matters.

The probiotic product being provided by the hospitals is the popular yoghurt drink 'Actimel' produced by Danone. The drink contains the probiotic bacteria Lactobacillus casei immunitass and has been well studied with favourable results. A 2007 study found that drinking two pots a day stopped diarrhoea symptoms caused by C.diff and antibiotics.

Matthew Fletcher, medical director of Brighton and Sussex University Hospitals NHS Trust which is responsible for the two hospitals, said: "We are providing Actimel probiotic yoghurt to patients on the wards where we have previously had more cases of C.diff.

"There is some evidence to suggest that using these probiotics may reduce a patient's risk of C.diff and we will be evaluating the difference this has made to the number of cases."

With C. diff becoming a bigger problem many other hospitals and health authorities will no doubt be watching the trial with interest.



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