Probiotic Lactobacillus GG to Eliminate VRE Colonization

Exclusion Criteria

• •1. Inpatients
• •2. Active infection with VRE being treated
• •3. Pregnancy
• •4. Known use of LGG or another probiotic (not including yogurt) within the previous 30 days
• •5. Presence of an active bowel leak, acute abdomen, active intestinal disease, or significant bowel dysfunction
• •6. Presence of an absolute neutrophil count less than 500 per cubic mm or anticipation post chemotherapy that the absolute neutrophil count will fall below 500 per cubic mm
• •7. History of adverse reaction to product containing lactobacillus
• •8. Active colitis (see definition below)
• •9. Treatment with an antibiotic with activity against VRE
• •10. Life expectancy less than one year or life-threatening condition
• •11. Known or suspected allergies to probiotics, lactobacillus, milk protein, and microcrystalline cellulose
• •12. Structural heart disease, history of endocarditis or valve replacement
• •13. Positive baseline stool culture for LGG
• •14. Recent or planned chemotherapy or radiation therapy
• •15. Solid organ transplant within the prior year
• •16. Stem cell transplant within the prior year
• •17. On active immunosuppressive medication \[anti-rejection, injectable immunosuppressive drugs for autoimmune disease, or corticosteroids (greater than 1/2 mg per kg body weight of prednisone or its equivalent) not including inhaled or topical steroids\]
• •18. Allergy or intolerance to or contraindication to two or more of the rescue antibiotic regimens (ampicillin, clindamycin, moxifloxacin)
• •Colitis will be defined as a history of Crohn's disease or ulcerative colitis with active diarrhea, active diarrhea due to Clostridium difficile infection, active diarrhea due to known or unknown cause with a stool specimen showing fecal leukocytes (if none has been done in such a patient this will be requested prior to enrollment). Diarrhea will be defined as more than three unformed bowel movements per day. The subject's primary physician will be asked to assess the subject's life expectancy, and subjects with an estimated life expectancy of less than one year as judged by the physician who knows him or her best will be excluded.