Background and Significance: The advent of broad spectrum antibiotic therapy has led to an increase in antibiotic associated diarrhea. This phenomenon appears to be related to an alteration in the intestinal flora caused by the antibiotics leaving the intestinal mucosa open to pathogens. The antibiotic associated diarrhea is a significant complication of antibiotic administration responsible for patient discomfort, increased nurse and allied health workload, potential early cessation of antibiotic therapy, increased length of hospital stay and costly interventions.

Literature search: Medline, CINAHL, and the Cochrane Database of Systematic Reviews were searched using keywords “probiotics, “diarrhea”, “antibiotic associated diarrhea”. Numerous studies were found to support the use of probiotics in the prevention of antibiotic associated diarrhea.  In a meta analysis conducted by D’Souza et al, (2002) the investigators reviewed nine randomized, double blind, placebo controlled trials of probiotic use in the prevention of diarrhea. The outcome measure used was the percentage of patients without diarrhea in the probiotic and placebo groups. Based on the results of the meta analysis the authors suggest that probiotics can be used to prevent antibiotic associated diarrhea.

 Evidence-based Practice Approach: Staff nurses on a cardiovascular unit, the Unit Educator, along with the Director of Library Services searched the literature for valid evidence to support a clinical practice change. An interdisciplinary team was formed to further investigate the potential need for, as well as the feasibility of implementing an organization wide probiotic protocol for patients receiving multiple antibiotics in order to prevent the development of diarrhea. The process of implementing this Evidence-Based Practice change, along with lessons learned and outcomes will be shared with the audience during this presentation.