T. Saintmarc et al., AIDS-RELATED DIARRHEA - A DOUBLE-BLIND TRIAL OF SACCHAROMYCES-BOULARDII, La Semaine des hopitaux de Paris, 71(23-24), 1995, pp. 735-741
Chronic AIDS-related diarrhea remains a problem because of its persist
ence and variable response to available treatments. Saccharomyces boul
ardii (Sb) is a nonpathogenic yeast used to treat diarrhea with gut mi
croflora alterations. This double-blind, placebo-controlled, parallel-
group trial in 35 patients with Stage IV AIDS was conducted to evaluat
e the efficacy of Sb in AIDS-related diarrhea unresponsive to standard
therapy. Mean age was 34.9 years. Most patients were male. The cause
of the diarrhea was identified in 54.3% of cases (cryptosporidiosis in
20%). Eighteen patients were assigned to Sb therapy and 17 to placebo
therapy. The two groups were comparable at baseline. Resolution of di
arrhea was recorded in 61% of Sb patients versus 12% of placebo patien
ts after one week (p<0.002). Significant improvements were also noted
in the Sb group regarding the daily diarrhea score based on stool numb
er, weight, and volume (p<0.002); abdominal pain; abdominal distension
; asthenia; weight gain; and the Karnofsky index. Tolerability was out
standing. Our data show that over a one-week period Sb is an effective
symptomatic treatment for persistent AIDS-related diarrhea. The patho
physiologic mechanism underlying this beneficial effect and the long-t
erm efficacy of Sb remain to be determined. Sb was as effective in rel
ieving diarrhea in this study as in previously published studies in ot
her indications.