ClinicalTrials.gg
TerminatedNCT01972932Updated Jul 22, 2022

Study of Bio-K+® in the Reduction of the Risk of Clostridium Difficile Infection and Antibiotic Associated Diarrhea

A Phase 4 interventional study of Bio K+® 2 capsules orally (or via nasogastric tube) and Placebo in Clostridium Difficile Infection and Antibiotic Associated Diarrhea, sponsored by Bio-K Plus International Inc.. Terminated at 1 site in Canada. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2022-07-22.

Sponsored by Bio-K Plus International Inc. (part of Kerry Group plc) · Phase 4, Interventional, and Prevention

Why this study was terminated
Recruitment problems
Phase
Phase 4
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 90 Years
Sex
All
01

Study summary

Antibiotic-associated diarrhea (AAD) and particularly Clostridium difficile-Infection (CDI) are the most common causes of healthcare associated infectious diarrhea. In light of the results obtained in a limited number of randomized clinical trials in subjects with AAD and CDI in comparison with the widespread occurrence of these diseases, it is felt that the addition of a well-controlled clinical trial in a western environment would add value to support the use of a specific probiotic to counteract these diseases.

Read the detailed description

The prevalence of Clostridium difficile infection (CDI) has been on the rise in the United States, and in fact the Centers for Disease Control and Prevention (CDC) identified CDI as one of the highest threats in its recent report on antibiotic resistance in the United States. This designation as an "urgent threat" highlights the need for immediate and aggressive action to prevent this infection.

In fact, CDI has been reported as the most commonly reported pathogen causing healthcare-associated infections (HAIs). A point prevalence survey of 183 hospitals in 10 states found that C. difficile comprised 12.1% of HAIs, surpassing Staphylococcus aureus infections.

Although most cases of CDI can be treated successfully with relatively safe and effective oral antibiotics (i.e., metronidazole or vancomycin), primary prevention of CDI is critical because up to one in five treated patients endures a relapse or reinfection, which can be difficult to treat; infected patients serve as a reservoir for ongoing transmission within facilities; implementation of contact isolation precautions for patients who have CDI can have deleterious consequences for the patient; and, CDI can result in death or severe disease including those treated by colectomy. Because CDI is spread between patients, prevention of a single case should reduce the risk of exposure for other hospital patients.

One of the main studies in this indication, being a quality improvement study conducted at Pierre Le Gardeur Hospital (PLGH) in province of Québec, Canada. Starting in 2004, 10 years of surveillance data were reported from this hospital that administers Bio-K Plus to all antibiotic users. During the 10 years of observation, 44, 835 inpatients received Bio-K+, and the CDI rate at PLGH declined from 18.0 cases per 10,000 patient-days and remained at low mean levels of 2.3 cases per 10 000 patient-days.

Additionally, 10-year data collected by the Ministry of Health in Quebec comparing the CDI rate between Quebec hospitals showed that CDI rates at PLGH were consistently and continuously lower compared with those at similar hospitals.

In conclusion, adding Bio-K Plus as a standard treatment led to a dramatic and sustained decrease in the incidence of C. difficile infections at this hospital.

02

Conditions studied

  • Clostridium Difficile Infection
  • Antibiotic Associated Diarrhea

Keywords

  • Bio-K+®
  • Placebo
  • AAD
  • CDI
  • hospitalized subjects
03

In context

Clostridium Infections

313 studies on the registry are indexed under Clostridium Infections; 51 are open to participants now.

This study's enrollment of 60 is close to the median of 64 across 235 interventional studies indexed under Clostridium Infections.

Browse Clostridium Infections studies →

Lead sponsor

Bio-K Plus International Inc. is the lead sponsor of 8 studies on the registry; none are open to participants now.

First submitted before Bio-K Plus International Inc. became part of Kerry Group plc.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Only subjects who meet the following inclusion criteria will be eligible to participate in the study:

  • Are at least 18 years old
  • Able to tolerate food intake Antibiotic treatment started less than 48hrs from admission into the study
  • Have an expected hospitalization period of at least three days (including subject"s stay in the emergency room)
  • Speak and understand English and/or French.
  • Have an expected survival greater than 60 days
  • Agree to refrain from taking probiotic products (besides the study drug) during the study period Have given informed consent In addition, women of child bearing capacity who are not pregnant at the moment of screening (pregnancy test done on-site) and agree to use an acceptable form of birth control for the duration of the study (e.g. Condom, oral contraceptives, etc.) are allowed to participate.

Exclusion criteria

Exclusion Criteria

Subjects who meet any of the following exclusion criteria will not be eligible to participate in the study:

  • Have been diagnosed with CDI in previous sixty days
  • Have taken Streptomycin, oral Vancomycin, or Metronidazole in the last 4 weeks, excluding as part of the treatment regimen triggering their inclusion into the study.
  • Are currently suffering from any health condition causing immunosuppression (including haematological malignancies, lymphoma, AIDS, transplant, and hemodialysis)
  • Have received more than 10 mg of prednisone per day for at least 1 month within 3 months prior to the participation to the study.
  • Have active diarrhea (three or more liquid stools per 24 hour period) or non-controlled intestinal disease/colitis such as Crohn's disease, ulcerative colitis or caeliac disease Have stomas, are ostomized or are parenteral nutrition users Have already been randomized to one arm of this study
  • Are known to have shown a previous reaction, including anaphylaxis, to any substance in the composition of the study products (i.e. Non-medicinal ingredients: Cellulose, hypromellose, medium chain triglycerides, sodium alginate, ascorbic acid, magnesium stearate (vegetal source), silicon dioxide and titanium dioxide
  • Where receiving systemic antibiotics on admission to the hospital or who have been treated with antibiotics over the past two weeks Have lactose intolerance or milk allergy
  • Have difficulties giving informed consent because of chronic mental disease, dementia
  • Are not likely to comply with study requirements (provide stool for screening if diarrhea or answer to the follow up questionnaires)
  • Have been known to use illicit drugs in the last two years. Have participated in another clinical study in the last 30 days
  • Female subjects that are pregnant, or who intend to become pregnant or are lactating during the study period
  • Female subjects of child bearing potential not currently using adequate contraception
05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
60 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    Placebo 2 capsules orally (or via nasogastric tube) once per day starting randomization until five days after the discontinuation of the antibiotic.

    Dietary Supplement: Placebo

  • Active comparator
    Bio K+®

    Bio K+® 2 capsules orally (or via nasogastric tube) once per day starting at randomization until five days after the discontinuation of the antibiotic.

    Dietary Supplement: Bio K+® 2 capsules orally (or via nasogastric tube)

Interventions

  • Dietary supplementBio K+® 2 capsules orally (or via nasogastric tube)

    Bio-K+® 2 capsules orally (or via nasogastric tube) once per day starting at randomization until five days after the discontinuation of the antibiotic.

    Also known as: Bio-K+®

  • Dietary supplementPlacebo

    Placebo Comparator: 2 capsules orally (or via nasogastric tube) once per day starting randomization until five days after the discontinuation of the antibiotic.

06

What researchers measure

Primary outcomes

  1. To evaluate the incidence of Clostridium Difficile infection

    The primary objective of this study is evaluate the incidence risk ratio of CDI in hospitalized subjects treated with systemic antibiotics, taking oral administration of Bio-K+® in comparison with a placebo. Risk will be calculated for the period of antibiotic treatment plus 65 days.

    Time frame: 2 Years

Secondary outcomes

  1. To evaluate the incidence of antibiotic associated diarrhea

    * To evaluate the incidence of AAD * To evaluate the incidence of RCDI * To determine the time to occurrence of the first symptoms (first liquid stool) of AAD or CDI - * To evaluate the impact on the duration of hospitalization * To evaluate the number of emergency room visits and re-hospitalizations for AAD or CDI * To determine the mean costs for the initial hospitalization * To evaluate the safety profile of Bio-K+®

    Time frame: 2 Years

07

Study locations

1 site
  • Centre Hospitalier de l'Université de Montréal
    Montreal, Quebec, Canada
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 22, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT01972932
Responsible party
Sponsor
First posted
Oct 31, 2013
Start date
Nov 2013
Primary completion
Nov 2014
Completion
Aug 2017
Last update
Jul 22, 2022

Study contacts

Mikhael Laskine, MD
principal investigator · Centre hospitalier de l'Université de Montréal (CHUM)
Serge Carriere, MD
study director · Bio-K+International Inc.

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Jul 2022. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion