Pediatric Clostridium difficile: A Phantom Menace or Clinical Reality?

Self Cite

Background:Little information is available on the epidemiologic characteristics of antibiotic‐associated diarrhea (AAD) in children. The authors' aim was to evaluate the incidence of AAD in an outpatient pediatric population and to identify risk factors.Methods:Children aged 1 month to 15.4 years treated with oral antibiotics for a proven or suspected infection were enrolled from an ambulatory pediatric practice during an 11‐month period. Parents recorded the daily frequency and characteristics of stools using a diary during the antibiotic treatment and for 1 week after it was stopped. An episode of diarrhea was defined by at least 3 soft or liquid stools/d for at least 2 consecutive days. Risk factors for AAD—age, type of antibiotic treatment, type of combined treatment, and site of infection— were analyzed.Results:Of 650 children included, 11% had an episode of AAD, lasting a mean of 4.0 ± 3.0 days, beginning a mean of 5.3 ± 3.5 days after the start of antibiotic treatment. No child was hospitalized because of AAD. The incidence of AAD was higher in children less than 2 years (18%) than in those more than 2 years (3%; P < 0.0001). The incidence of AAD was particularly high after administration of certain antibiotics (amoxicillin/clavulanate, 23%; P = 0.003 compared with other antibiotics). The type of combined treatment and site of infection did not influence the onset of AAD.Conclusions:Antibiotic‐associated diarrhea was common in these outpatient children, especially for those aged less than 2 years and after the prescription of certain antibiotics, particularly, the combination of amoxicillin/clavulanate. JPGN 37:22‐26, 2003.

Incidence and Risk Factors of Oral Antibiotic‐Associated Diarrhea in an Outpatient Pediatric Population

Turck,

Bernet,

Marx

et al. 2003

Self Cite

Probiotics in Gastrointestinal Diseases in Children

Szajewska¹,

Setty²,

Mrukowicz³

et al. 2006

Self Cite

143

The use of probiotics, once discussed primarily in the context of alternative medicine, is now entering mainstream medicine. However, only a few of the potential health benefits attributed to probiotics have been confirmed in well-designed, well-conducted, randomized, controlled trials. This is especially true in the pediatric population. We review here the available evidence on efficacy of probiotics in children in the prevention and treatment of gastrointestinal diseases. Although we restrict our analysis to the pediatric age, whenever potentially relevant information is available only from adult studies, they are examined as well. Probiotics have been most extensively studied in the treatment of diarrheal diseases, where their efficacy can be considered well established. Studies documenting effects in other childhood gastrointestinal illnesses are few, although some preliminary results are promising. Furthermore, only a limited number of probiotic strains have been tested, and, as the effects of different probiotic microorganisms are not equivalent, results cannot be generalized. Thus, at present, we have some positive certainties, lots of exciting promises and many unanswered questions.

Exposure to Gastric Acid–Suppression Therapy Is Associated With Health Care– and Community‐Associated Clostridium difficile Infection in Children

Jimenez

Drees²,

Loveridge-Lenza

et al. 2015