Trial Outcomes & Findings for Mechanisms of Preventing Antibiotic-Associated Diarrhea and the Role for Probiotics (NCT NCT03755765)

NCT ID: NCT03755765

Last Updated: 2023-02-17

Results Overview

Level of fecal short-chain fatty acid acetate (SCFA) after administration of amoxicillin clavulanate

Recruitment status

COMPLETED

Study phase

EARLY_PHASE1

Target enrollment

66 participants

Primary outcome timeframe

day 0 (post run-in), 7, 14, 21, 30

Results posted on

2023-02-17

Participant Flow

Participant milestones

Participant milestones
Measure
Control
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Not Randomized
Withdrawals prior to randomization
Overall Study
STARTED
20
42
4
Overall Study
COMPLETED
18
38
0
Overall Study
NOT COMPLETED
2
4
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Control
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Not Randomized
Withdrawals prior to randomization
Overall Study
Withdrawal by Subject
2
4
4

Baseline Characteristics

Mechanisms of Preventing Antibiotic-Associated Diarrhea and the Role for Probiotics

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control
n=20 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=42 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Not Randomized
n=4 Participants
Withdrawals prior to randomization
Total
n=66 Participants
Total of all reporting groups
Age, Continuous
29.4 years
STANDARD_DEVIATION 8.1 • n=5 Participants
29.6 years
STANDARD_DEVIATION 10.3 • n=7 Participants
31.8 years
STANDARD_DEVIATION 21.6 • n=5 Participants
29.7 years
STANDARD_DEVIATION 10.6 • n=4 Participants
Sex/Gender, Customized
Female
11 Participants
n=5 Participants
23 Participants
n=7 Participants
1 Participants
n=5 Participants
35 Participants
n=4 Participants
Sex/Gender, Customized
Male
9 Participants
n=5 Participants
18 Participants
n=7 Participants
3 Participants
n=5 Participants
30 Participants
n=4 Participants
Sex/Gender, Customized
Not reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
18 Participants
n=5 Participants
36 Participants
n=7 Participants
4 Participants
n=5 Participants
58 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
4 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
6 Participants
n=7 Participants
3 Participants
n=5 Participants
12 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
8 Participants
n=7 Participants
0 Participants
n=5 Participants
13 Participants
n=4 Participants
Race (NIH/OMB)
White
11 Participants
n=5 Participants
28 Participants
n=7 Participants
1 Participants
n=5 Participants
40 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Health insurance status
Yes
20 Participants
n=5 Participants
41 Participants
n=7 Participants
4 Participants
n=5 Participants
65 Participants
n=4 Participants
Health insurance status
No
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Household smoking
No
18 Participants
n=5 Participants
40 Participants
n=7 Participants
4 Participants
n=5 Participants
62 Participants
n=4 Participants
Household smoking
Yes
2 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Marital status
Married
4 Participants
n=5 Participants
10 Participants
n=7 Participants
0 Participants
n=5 Participants
14 Participants
n=4 Participants
Marital status
Living with a partner
2 Participants
n=5 Participants
5 Participants
n=7 Participants
0 Participants
n=5 Participants
7 Participants
n=4 Participants
Marital status
Single
14 Participants
n=5 Participants
26 Participants
n=7 Participants
3 Participants
n=5 Participants
43 Participants
n=4 Participants
Marital status
Separated
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Marital status
Divorced
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Marital status
Widowed
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Annual gross total income
Less than $15,000
1 Participants
n=5 Participants
6 Participants
n=7 Participants
0 Participants
n=5 Participants
7 Participants
n=4 Participants
Annual gross total income
$15,000-$29,999
1 Participants
n=5 Participants
3 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Annual gross total income
$30,000-$49,999
1 Participants
n=5 Participants
5 Participants
n=7 Participants
0 Participants
n=5 Participants
6 Participants
n=4 Participants
Annual gross total income
$50,000-$74,999
1 Participants
n=5 Participants
5 Participants
n=7 Participants
0 Participants
n=5 Participants
6 Participants
n=4 Participants
Annual gross total income
$75,000-$99,999
5 Participants
n=5 Participants
6 Participants
n=7 Participants
0 Participants
n=5 Participants
11 Participants
n=4 Participants
Annual gross total income
$100,000-$150,999
2 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Annual gross total income
$150,000-$200,000
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Annual gross total income
More than $200,000
2 Participants
n=5 Participants
6 Participants
n=7 Participants
3 Participants
n=5 Participants
11 Participants
n=4 Participants
Annual gross total income
Prefer not to answer
0 Participants
n=5 Participants
3 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
Annual gross total income
Unknown/Not Reported
6 Participants
n=5 Participants
5 Participants
n=7 Participants
1 Participants
n=5 Participants
12 Participants
n=4 Participants

PRIMARY outcome

Timeframe: day 0 (post run-in), 7, 14, 21, 30

Population: Number of samples received

Level of fecal short-chain fatty acid acetate (SCFA) after administration of amoxicillin clavulanate

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=29 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Level of Fecal Short-chain Fatty Acid (SCFA) Acetate
Day 0
53.1 micromolar (μM)
Standard Deviation 18.0
45.2 micromolar (μM)
Standard Deviation 20.3
Level of Fecal Short-chain Fatty Acid (SCFA) Acetate
Day 7
42.3 micromolar (μM)
Standard Deviation 17.5
38.1 micromolar (μM)
Standard Deviation 17.6
Level of Fecal Short-chain Fatty Acid (SCFA) Acetate
Day 14
36.8 micromolar (μM)
Standard Deviation 11.1
40.8 micromolar (μM)
Standard Deviation 16.1
Level of Fecal Short-chain Fatty Acid (SCFA) Acetate
Day 21
43.8 micromolar (μM)
Standard Deviation 17.6
50.5 micromolar (μM)
Standard Deviation 20.9
Level of Fecal Short-chain Fatty Acid (SCFA) Acetate
Day 30
39.8 micromolar (μM)
Standard Deviation 14.3
44.5 micromolar (μM)
Standard Deviation 14.1

SECONDARY outcome

Timeframe: day 0 (post run-in), 7, 14, 21, 30

Population: Number of samples received

Level of fecal short-chain fatty acid propionate after administration of amoxicillin clavulanate

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=29 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Level of Fecal SCFA Propionate
Day 0
14.3 μM
Standard Deviation 9.1
13.0 μM
Standard Deviation 7.2
Level of Fecal SCFA Propionate
Day 7
14.3 μM
Standard Deviation 6.7
12.5 μM
Standard Deviation 6.0
Level of Fecal SCFA Propionate
Day 14
11.8 μM
Standard Deviation 6.9
12.0 μM
Standard Deviation 6.1
Level of Fecal SCFA Propionate
Day 21
11.0 μM
Standard Deviation 3.5
14.8 μM
Standard Deviation 7.8
Level of Fecal SCFA Propionate
Day 30
11.4 μM
Standard Deviation 7.3
11.5 μM
Standard Deviation 5.7

SECONDARY outcome

Timeframe: day 0 (post run-in), 7, 14, 21, 30

Population: Number of samples received

Level of fecal short-chain fatty acid butyrate (μM) after administration of amoxicillin clavulanate

Outcome measures

Outcome measures
Measure
Control
n=12 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=29 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Level of Fecal SCFA Butyrate
Day 0
12.7 μM
Standard Deviation 6.2
12.7 μM
Standard Deviation 8.4
Level of Fecal SCFA Butyrate
Day 7
9.0 μM
Standard Deviation 5.3
8.3 μM
Standard Deviation 5.7
Level of Fecal SCFA Butyrate
Day 14
7.4 μM
Standard Deviation 4.3
8.9 μM
Standard Deviation 6.1
Level of Fecal SCFA Butyrate
Day 21
11.6 μM
Standard Deviation 9.2
11.9 μM
Standard Deviation 7.8
Level of Fecal SCFA Butyrate
Day 30
8.3 μM
Standard Deviation 5.3
9.9 μM
Standard Deviation 4.0

OTHER_PRE_SPECIFIED outcome

Timeframe: day 0 (pre run-in), 7, 14, 21, 30

Population: Number of samples received

The Shannon diversity metric is a measure of community diversity and takes into account species richness (number of distinct taxa) and the relative abundance of each taxon. The Shannon diversity index was calculated for samples at each time point from subjects receiving control or BB-12 yogurt. The first of two baseline samples was collected from each subject at the time of enrollment (pre run-in) before a 30-day run-in period in which the consumption of dietary probiotics was stopped. A higher index indicates more diversity and a lower index indicates less diversity.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=38 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Change in Community Diversity (Shannon Diversity Index) From Pre run-in Baseline
Day 0 Pre run-in
3.711 Shannon Diversity Index
Standard Deviation 0.349
3.774 Shannon Diversity Index
Standard Deviation 0.302
Change in Community Diversity (Shannon Diversity Index) From Pre run-in Baseline
Day 7
3.380 Shannon Diversity Index
Standard Deviation 0.364
3.567 Shannon Diversity Index
Standard Deviation 0.479
Change in Community Diversity (Shannon Diversity Index) From Pre run-in Baseline
Day 14
3.419 Shannon Diversity Index
Standard Deviation 0.465
3.632 Shannon Diversity Index
Standard Deviation 0.307
Change in Community Diversity (Shannon Diversity Index) From Pre run-in Baseline
Day 21
3.709 Shannon Diversity Index
Standard Deviation 0.322
3.708 Shannon Diversity Index
Standard Deviation 0.308
Change in Community Diversity (Shannon Diversity Index) From Pre run-in Baseline
Day 30
3.395 Shannon Diversity Index
Standard Deviation 0.409
3.684 Shannon Diversity Index
Standard Deviation 0.397

OTHER_PRE_SPECIFIED outcome

Timeframe: day 0 (post run-in), 7, 14, 21, 30

Population: Number of samples received

The Shannon diversity metric is a measure of community diversity and takes into account species richness (number of distinct taxa) and the relative abundance of each taxon. The Shannon diversity index was calculated for samples at each time point from subjects receiving control or BB-12 yogurt. The second baseline sample was collected from each subject after a 30-day run-in period in which the consumption of dietary probiotics was stopped (post run-in). A higher index indicates more diversity and a lower index indicates less diversity.

Outcome measures

Outcome measures
Measure
Control
n=18 Participants
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=38 Participants
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Change in Community Diversity (Shannon Diversity Index) From Post run-in Baseline
Day 0 Post run-in
3.845 Shannon Diversity Index
Standard Deviation 0.290
3.718 Shannon Diversity Index
Standard Deviation 0.261
Change in Community Diversity (Shannon Diversity Index) From Post run-in Baseline
Day 7
3.528 Shannon Diversity Index
Standard Deviation 0.396
3.606 Shannon Diversity Index
Standard Deviation 0.494
Change in Community Diversity (Shannon Diversity Index) From Post run-in Baseline
Day 14
3.496 Shannon Diversity Index
Standard Deviation 0.486
3.666 Shannon Diversity Index
Standard Deviation 0.304
Change in Community Diversity (Shannon Diversity Index) From Post run-in Baseline
Day 21
3.785 Shannon Diversity Index
Standard Deviation 0.295
3.727 Shannon Diversity Index
Standard Deviation 0.278
Change in Community Diversity (Shannon Diversity Index) From Post run-in Baseline
Day 30
3.486 Shannon Diversity Index
Standard Deviation 0.444
3.712 Shannon Diversity Index
Standard Deviation 0.391

OTHER_PRE_SPECIFIED outcome

Timeframe: day 0, 7, 14, 21, 30

Community divergence over time with respect to the baseline sample (post run-in, day 0)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: day 7, 14, 21, 30

Change in diarrhea/stool frequency from baseline

Outcome measures

Outcome data not reported

Adverse Events

Control

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

BB-12

Serious events: 0 serious events
Other events: 25 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Control
n=18 participants at risk;n=20 participants at risk
Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Control: Yogurt without Bifidobacterium animalis subsp. lactis BB-12 (BB-12)
BB-12
n=38 participants at risk;n=42 participants at risk
Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-supplemented yogurt and Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet: Amoxicillin-Clavulanate 875 Mg-125 Mg Oral Tablet BB-12: Bifidobacterium animalis subsp. lactis BB-12-supplemented yogurt
Gastrointestinal disorders
Loose stool
50.0%
9/18 • Pre-run in baseline to day 30
36.8%
14/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Diarrhea
5.6%
1/18 • Pre-run in baseline to day 30
2.6%
1/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Constipation
16.7%
3/18 • Pre-run in baseline to day 30
10.5%
4/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Flatulence
44.4%
8/18 • Pre-run in baseline to day 30
21.1%
8/38 • Pre-run in baseline to day 30
General disorders
Lack/Loss of Appetite
16.7%
3/18 • Pre-run in baseline to day 30
5.3%
2/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Stomach Pain
16.7%
3/18 • Pre-run in baseline to day 30
2.6%
1/38 • Pre-run in baseline to day 30
General disorders
Rash
0.00%
0/18 • Pre-run in baseline to day 30
5.3%
2/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Vomiting
0.00%
0/18 • Pre-run in baseline to day 30
5.3%
2/38 • Pre-run in baseline to day 30
Gastrointestinal disorders
Dyspepsia
16.7%
3/18 • Pre-run in baseline to day 30
2.6%
1/38 • Pre-run in baseline to day 30
General disorders
Nausea
27.8%
5/18 • Pre-run in baseline to day 30
7.9%
3/38 • Pre-run in baseline to day 30
General disorders
Other
33.3%
6/18 • Pre-run in baseline to day 30
18.4%
7/38 • Pre-run in baseline to day 30

Additional Information

Daniel Merenstein, MD

Department of Family Medicine, Georgetown University Medical Center

Phone: 202-687-2745

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place