Changes to gut microbiota as a result of EN or antibiotic use can lead to increased susceptibility to infectious pathogens such as Clostridium difficile. A Cochrane review of thirty‐nine studies (n= 9,955) found that in patients receiving antibiotic therapy, probiotics reduced the risk of clostridium difficile-associated diarrhoea (CDAD) by 60%.10
Probiotic administration also reduced the incidence of CDAD-related symptoms (including abdominal cramping, nausea, fever, soft stools, flatulence, and taste disturbance) in 17% of participants. Based on this systematic review, it can be concluded that probiotics are effective for the management of CDAD. However, it is important to note that these participants were not receiving enteral nutrition; further research is required to examine the role of probiotics and management of CDAD in enterally tube fed patients.