Prevention of dysbiosis and antibiotic-associated diarrhea in children with acute respiratory infections after antibiotic therapy

Abstract

Aim: to develop a method of dysbiotic abnormality prevention after antibiotic therapy (ABT) in early childhood. Patients and Methods: the study enrolled 90 children aged 12–60 months who were admitted to the hospital with complicated acute respiratory infections (ARIs) and received ABT. The children were randomized into three groups (each comprised of 30 children). The children received either a probiotic with Lactobacillus rhamnosus GG and Bifidobacterium BB-12 (group 1) or a cytomucoprotector, gelatin tannate (group 2) to prevent antibiotic-associated diarrhea (AAD). Group 3 children received ABT only. To assess microbiocenosis, short-chain fatty acids (SCFAs) in stool were measured by gas-liquid chromatography. Results: AAD was reported in 23.3% of group 1 children, 17% of group 2 children, and 46.7% of group 3 children (p=0.03). In group 2, the duration of diarrhea was significantly lower. Baseline stool concentration of SCFAs was 2.5-times lower compared to normal ranges. Further reduction in the total absolute level of SCFAs was reported in group 3 after treatment. An increase in total SCFA level, a significant increase in the relative amounts of acetic acid, and a reduction in propionic acid and (to a lesser degree) butyric acid were reported in groups 1 and 2 compared to group 3. Conclusions: an improvement in stool SCFA levels was reported in group 1 and 2 children who received probiotics or cytomucoprotector. Incorporation of these medications and ABT in the complex treatment for ARIs in children stabilized metabolic activity of microbiota through preserving the pool of indigenous microorganisms producing butyrate. KEYWORDS: antibiotic, antibiotic-associated diarrhea, acute respiratory viral infections, microbiota, short-chain fatty acids, probiotic, gelatin tannate. FOR CITATION: Mazankova L.N., Perlovskaya S.G., Ardatskaya M.D. et al. Prevention of dysbiosis and antibiotic-associated diarrhea in children with acute respiratory infections after antibiotic therapy. Russian Medical Inquiry. 2021;5(11):712–720 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-712-720.