Microbe of the Month: A cure in your beer: Bernard Dixon looks at how brewer's yeast is used to treat severe diarrhoea

Administering one microbe to a patient in order to fight disease caused by another is an idea of beguiling simplicity. Unfortunately, despite several initially promising attempts, that theoretical strategy has never been translated into practical success.

Now, as described in the Lancet, work at St Charles and St Mary's hospitals, both in London, shows that the microbe which makes beer can be used to cure a dangerous and previously difficult-to-treat condition.

The infection in question is a severe form of diarrhoea, caused by the bacterium Clostridium difficile, which sometimes leads to potentially lethal colitis (inflammation of the colon).

Doctors have been exploiting the power of microbes for several decades. Bacteria and fungi provide the penicillin streptomycin and other antibiotics that have advanced our capacity to treat diseases such as lobar pneumonia and tuberculosis. But this revolution, based on the realisation that some microbes produce substances (antibiotics) that are lethal to others, has not led to the successful inoculation of microbes themselves into the body as a therapeutic measure.

The infection treated by David Schellenberg and his colleagues at St Charles and St Mary's hospitals is known as C. difficile diarrhoea. Although first recognised many years ago, often following surgery on the intestinal canal, this type of diarrhoea (accompanied by cramps and other symptoms) is unusual in having become more common with the advent of antibiotics.

C. difficile (so named because it is difficult to grow in the laboratory) can thrive when antibiotic therapy alters the balance of bacteria growing in the intestine. It may then begin to produce the poisons that damage the intestinal wall in colitis.

Although C. difficile diarrhoea does not always precipitate lethal colitis, the condition itself may be extremely severe. In addition, while it responds to drugs such as vancomycin and metronidazole, up to a fifth of individuals treated in this way later relapse.

Schellenberg and his colleagues decided to send brewer's yeast to war against C. difficile in light of reports a few years ago that another yeast, Saccharomyces boulardii, can be used to prevent diarrhoea associated with antibiotic therapy and to treat recurrent colitis caused by C. difficile. Unfortunately, administration of S. boulardii has a serious side-effect, in that the living yeast cells can pass into the bloodstream.

They are especially likely to do so in patients whose immune systems are deficient - for example, as a consequence of Aids or as a result of treatment with drugs to prevent the rejection of a transplanted organ.

The results reported in the Lancet indicate that brewer's yeast (also known as Saccharomyces cerevisiae) is a safe answer to the problem. It certainly worked for each of three individuals in whom conventional treatment had achieved only transient success.

One patient was a 79-year- old man who suffered profuse diarrhoea associated with C. difficile for two days after antibiotic therapy. The problem abated when he was given vancomycin. Thirteen days later it recurred and he was treated with metronidazole. Again the diarrhoea went away, but came back within another 14 days. Put on to brewer's yeast tablets, however, the man recovered within three days and he remained well eight weeks later.

Another patient was a man aged 69 whose diarrhoea returned after initially responding to vancomycin. Brewer's yeast tablets resolved the problem within three days, and he continued to be well six weeks afterwards. The third victim was an 87-year-old woman whose diarrhoea also failed to respond permanently to the two drugs. Within three days on yeast tablets, she was well again and remained so six weeks later.

It is still not clear how brewer's yeast brings about improvements of this sort. One possibility is that the yeast cells become attached to C. difficile, preventing its damaging actions. Or the yeast may work by altering the overall balance of microbes in the bowel. A third explanation is that it enhances the formation of protective antibodies. Whatever the explanation, there is considerable merit in a form of treatment that is not only highly effective but also easily administered and readily available. In addition, it is astonishingly cheap. NHS accountants will be overjoyed to learn that while the cost of a week's course of vancomycin is pounds 88.20, the bill for an equivalent supply of yeast tablets comes to

just 19p.

Suggested Topics
Sport
footballLIVE City face Stoke, while Warnock returns to Palace dugout
Arts and Entertainment
books
Life and Style
3D printed bump keys can access almost any lock
gadgets + techSoftware needs photo of lock and not much more
News
i100
PROMOTED VIDEO
Arts and Entertainment
Inside the gallery at Frederick Bremer School in Walthamstow
tvSimon Usborne goes behind the scenes to watch the latest series
Life and Style
Silvia says of her famous creation: 'I never stopped wearing it. Because I like to wear things when they are off the radar'
fashionThe fashion house celebrated fifteen years of the punchy pouch with a weighty tome
Arts and Entertainment
Gregg Wallace in Summer's Supermarket Secrets
tv All of this year's 15 contestants have now been named
News
i100Steve Carell selling chicken, Tina Fey selling saving accounts and Steve Colbert selling, um...
Life and Style
A picture taken on January 12, 2011 shows sex shops at the Paris district of Pigalle.
newsThe industry's trade body issued the moratorium on Friday
Arts and Entertainment
Could we see Iain back in the Bake Off tent next week?
tv Contestant teased Newsnight viewers on potential reappearance
News
ebooksAn evocation of the conflict through the eyes of those who lived through it
News
i100
News
The slice of Prince Charles and Princess Diana's wedding cake and the original box from 29 July 1981
newsPiece of Charles and Diana's wedding cake sold at auction in US
Voices
The Ukip leader has consistently refused to be drawn on where he would mount an attempt to secure a parliamentary seat
voicesNigel Farage: Those who predicted we would lose momentum heading into the 2015 election are going to have to think again
Arts and Entertainment
Cara Delevingne made her acting debut in Anna Karenina in 2012
film Cara Delevingne 'in talks' to star in Zoolander sequel
Sport
Mario Balotelli pictured in his Liverpool shirt for the first time
football
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Junior VB.NET Application Developer (ASP.NET, SQL, Graduate)

£28000 - £30000 per annum + Benefits + Bonus: Harrington Starr: Junior VB.NET ...

C# .NET Web Developer (ASP.NET, JavaScript, jQuery, XML, XLST)

£40000 - £50000 per annum + Benefits + Bonus: Harrington Starr: C# .NET Web De...

Clinical Negligence Solicitor

Highly Competitive Salary: Austen Lloyd: HAMPSHIRE MARKET TOWN - A highly attr...

Network Engineer (CCNP, CCNA, Linux, OSPF, BGP, Multicast, WAN)

£35000 per annum: Harrington Starr: Network Engineer (CCNP, CCNA, Linux, OSPF,...

Day In a Page

Ukraine crisis: The phoney war is over as Russian troops and armour pour across the border

The phoney war is over

Russian troops and armour pour into Ukraine
Potatoes could be off the menu as crop pests threaten UK

Potatoes could be off the menu as crop pests threaten UK

The world’s entire food system is under attack - and Britain is most at risk, according to a new study
Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

Seoul's plastic surgery industry is booming thanks to the popularity of the K-Pop look
From Mozart to Orson Welles: Creative geniuses who peaked too soon

Creative geniuses who peaked too soon

After the death of Sandy Wilson, 90, who wrote his only hit musical in his twenties, John Walsh wonders what it's like to peak too soon and go on to live a life more ordinary
Caught in the crossfire of a cyber Cold War

Caught in the crossfire of a cyber Cold War

Fears are mounting that Vladimir Putin has instructed hackers to target banks like JP Morgan
Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years

Salomé: A head for seduction

Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years. Now audiences can meet the Biblical femme fatale in two new stage and screen projects
From Bram Stoker to Stanley Kubrick, the British Library's latest exhibition celebrates all things Gothic

British Library celebrates all things Gothic

Forthcoming exhibition Terror and Wonder: The Gothic Imagination will be the UK's largest ever celebration of Gothic literature
The Hard Rock Café's owners are embroiled in a bitter legal dispute - but is the restaurant chain worth fighting for?

Is the Hard Rock Café worth fighting for?

The restaurant chain's owners are currently embroiled in a bitter legal dispute
Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival

In search of Caribbean soul food

Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival
11 best face powders

11 best face powders

Sweep away shiny skin with our pick of the best pressed and loose powder bases
England vs Norway: Roy Hodgson's hands tied by exploding top flight

Roy Hodgson's hands tied by exploding top flight

Lack of Englishmen at leading Premier League clubs leaves manager hamstrung
Angel Di Maria and Cristiano Ronaldo: A tale of two Manchester United No 7s

Di Maria and Ronaldo: A tale of two Manchester United No 7s

They both inherited the iconic shirt at Old Trafford, but the £59.7m new boy is joining a club in a very different state
Israel-Gaza conflict: No victory for Israel despite weeks of death and devastation

Robert Fisk: No victory for Israel despite weeks of devastation

Palestinians have won: they are still in Gaza, and Hamas is still there
Mary Beard writes character reference for Twitter troll who called her a 'slut'

Unlikely friends: Mary Beard and the troll who called her a ‘filthy old slut’

The Cambridge University classicist even wrote the student a character reference
America’s new apartheid: Prosperous white districts are choosing to break away from black cities and go it alone

America’s new apartheid

Prosperous white districts are choosing to break away from black cities and go it alone