Saccharomyces Boulardii News

April 4, 2001 - By Jill Stein

ISTANBUL, TURKEY -- April 4, 2001 -- Saccharomyces (S.) boulardii seems to be a valuable adjunctive agent for the treatment of recurrent Clostridium difficile-associated diarrhea (CDAD), researchers reported at the 11th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).

Dr. Thomas V. Riley and co-workers at the University of Western Australia in Perth have thus far treated 22 patients with recurrent CDAD with S. boulardii as an adjunct to conventional therapy.

Saccharomyces boulardii is a nonpathogenic yeast that survives gastric acidity, establishes in the colon, is not inhibited by antibiotics, does not affect normal flora, has been shown to prevent CDAD in animals and has a good safety profile. The yeast produces a protease that digests the toxin A and B molecules and also the A and B receptors on brush border membrane, which may partially account for its efficacy.

Patients in the study (all elderly) were treated with vancomycin for seven days plus lyophilised S. boulardii, 500 mg, twice daily given concurrently, and then continuing for another three weeks.

Eighteen patients had an uneventful recovery without additional relapses, three are still being treated, and one was lost to follow-up, Dr. Riley said.

Clostridium difficile-associated diarrhea is a serious hospital acquired infection that costs the healthcare system millions of dollars each year. The pathogenesis involves disruption of the gut microflora, usually by antibiotics, followed by infection with C. difficile, generally acquired from the hospital environment. Although poorly understood, diarrhea is thought to be due to the effects of an enterotoxin (toxin A) and a cytotoxin (toxin B).

Available treatments for CDAD include vancomycin, metronidazole, and other antibiotics as well as cholestyramine and probiotics. However, the relapse rate associated with such treatments is roughly 20 percent.

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