Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials

Johnston, Bradley C.; Supina, Alison L; Vohra, Sunita

doi:10.1503/cmaj.051603

Cited by 148 publications

(100 citation statements)

References 42 publications

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“…The reason for the partnership was only to obtain the product, which was provided without restriction on publication, whatever the results. 27 found that four of these, offering doses between 5.5 and 40×10 9 CFU/day of probiotics in different species or strains (L. casei GG, S. boulardii, and L. sporogens), demonstrated the protective effect of probiotics in AAD (RR 0.36, 95% CI 0.25 to 0.53), and in cases in which they used lower doses than 2×10 9 CFU/day, the benefit was not achieved. In the present study, the daily dose was 1.8×10 9 CFU, which may explain its ineffectiveness.…”

Section: Acknowledgmentsmentioning

confidence: 99%

The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

Souza

Jorge

2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Antibiotic-associated diarrhea (AAD) is an important side effect of this specific class of drugs. The objective of this study was to investigate the effect of the use of probiotics in the treatment of AAD. Methods: A group of hospitalized patients, who contracted diarrhea during or after 7 days of suspension of antimicrobial medication, was blindly randomized to receive a standardized diet associated with the use of the probiotics (Lactobacillus casei and Bifidobacterium breve) or its corresponding placebo, three times a day. Results: Seventy patients were studied. For the experimental (n=35) and control (n=35) groups, respectively, the average time of treatment was 5.06±2.18 and 5.49±3.17 days (p=0.95), and the average duration of diarrhea, among those who were healed, was 4.87±2.13 and 4.52±2.55 days (p=0.36). Four (11.4%) patients who received probiotics and ten (28.6%) who received the placebo were not cured (p=0.13), and relapse rates were similar between both groups. Seven patients from each group, in addition to diarrhea, presented cases of bloating and/or abdominal cramps and/or vomiting (p=1.00). Conclusions: In this light, it is concluded that L. casei associated with B. breve, in the administered dosage and frequency, has no effect on the antibiotic-associated diarrhea. Similar studies need to be conducted with higher doses of these or other probiotics. Keywords: Probiotics. Lactobacillus casei. Bifidobacterium breve. Antibiotic-associated diarrhea. RESUMO Introdução:A diarréia associada ao uso de antimicrobiano (DAA) é um importante efeito colateral dessa classe de fármacos. O objetivo do presente trabalho é investigar o efeito do uso de probióticos no tratamento da DAA. Métodos: Pacientes hospitalizados em um hospital universitário com diarréia, que se desenvolveu durante o uso ou até sete dias após a suspensão de antimicrobianos, foram randomizados, de forma cega, para receberem dieta padronizada associada, três vezes ao dia, ao uso de probiótico (Lactobacillus casei e Bifidobacterium breve) ou placebo. Resultados: Foram estudados um total de setenta pacientes. Para o grupo experimento (n=35) e controle (n=35), respectivamente, o tempo médio de tratamento foi de 5,06 ± 2,18 e 5,49 ± 3,17dias (p=0,95) e o tempo médio de duração da diarréia, entre aqueles que se curaram, foi de 4,87 ± 2,13 e 4,52 ± 2,55 dias (p=0,36). Quatro (11,4%) pacientes que receberam probióticos e dez (28,6%) que receberam placebo não foram curados (p=0,13) e a frequência de recidiva foi similar entre os grupos. Sete pacientes de cada grupo, além da diarréia, apresentaram distensão e/ou cólica abdominal e/ou vômito (p=1,00). Conclusões: L. casei associado a B. breve, na dosagem e frequência administradas, não demonstraram qualquer efeito no tratamento da diarréia associada a antimicrobiano. Estudos similares merecem ser realizados com doses maiores destes ou de outros probióticos. Palavras-chaves: Probióticos. Lactobacillus casei. Bifidobacterium breve. Diarréia associada ao uso de antimicrobiano.

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Section: Acknowledgmentsmentioning

confidence: 99%

The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

Souza

Jorge

2012

Rev. Soc. Bras. Med. Trop.

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“…В частности, было доказано, что применение пробио-тиков снижает риск развития ААД у детей на 28,5% [17][18][19]. В настоящее время широкое распространение в практической педиатрии получили препараты, содер-жащие в своем составе такие микроорганизмы, как L. acidophilus, Lactobacillus bulgaricus, B. longum, E. faecium, Saccharomyces boulardii [14,20].…”

Section: обмен опытомunclassified

Possibilities of Correction and Prophylaxis of Intestinal Microbiocenosis Disorders in Frequently Ill Children

Сурков¹

2013

Vopr. sovr. pediatr.

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Острые респираторные инфекции (ОРИ), будучи часто встречающейся патологией у детей всех возрастных групп, представляют достаточно серьезную проблему педиатрии. В России регистрируют до 70 тыс. случаев ОРИ на 100 тыс. детей в год. При этом максимальную частоту ОРИ фиксируют в возрасте от 6 мес до 6 лет, а среди этой группы наиболее высокий уровень заболе-ваемости отмечен у детей дошкольного возраста, посе-щающих организованные коллективы [1]. Особую группу пациентов составляют часто и длительно болеющие дети (ЧБД): врачам все чаще приходится проводить профилак-тическую работу, направленную на улучшение качества

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“…A pioneering study in this field was carried out by Vanderhoof et al 24 The authors assessed 188 children who had received antibiotics for the treatment of respiratory infections combined with Lactobacillus GG or placebo. 23,28 In one of these meta-analyses, which assessed six clinical trials carried out exclusively with children, the intention-totreat principle was also evaluated. 28 rhamnosus GG.…”

Section: Probiotics and Diarrheamentioning

confidence: 99%

“…23,28 In one of these meta-analyses, which assessed six clinical trials carried out exclusively with children, the intention-totreat principle was also evaluated. 28 rhamnosus GG. 31 Another study carried out in Finland compared whether the use of one probiotic, four probiotics or placebo had an additional effect on conventional treatment of atopic dermatitis in infants.…”

Section: Probiotics and Diarrheamentioning

confidence: 99%

O papel dos probióticos e prebióticos na prática pediátrica

Morais¹,

Jacob²

2006

J. Pediatr. (Rio J.)

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Objective: To review the effects of probiotics and prebiotics in clinical pediatric practice.Sources: MEDLINE was searched, especially for articles that addressed their practical application, in the form of reviews, clinical trials and meta-analyses. Articles that had already been analyzed by the authors were also included.Summary of the findings: Scientific literature on probiotics and prebiotics has remarkably increased in the last 10 years. Their mechanisms of action have been experimentally investigated. Studies indicate that probiotics can act by competing with pathogens, modifying the intestinal environment by reduction in pH, as a result of fermentation products, interacting and modulating local and systemic inflammatory and immune response, among others. Clinical trials and meta-analyses show that probiotics seem to contribute towards the prevention of acute diarrhea and of antibioticassociated diarrhea, in addition to shortening the duration of acute diarrhea. However, the data are inconsistent and there are no studies confirming their efficacy in terms of cost-benefit ratio. Preliminary studies show that probiotics in early life can reduce the occurrence of atopic dermatitis. The addition of prebiotics to infant formulas is associated with the change in the profile of the intestinal microbiota compared to infants fed milk formulas without prebiotics. Conclusions:Evidence indicates that new studies should be carried out about probiotics, prebiotics and symbiotics. The specific clinical effects that each probiotic or prebiotic may cause must be considered.J Pediatr (Rio J). 2006;82(5 Suppl):S189-97: Prebiotics, probiotics, symbiotics, lactobacillus, bifidobacteria, diarrhea. REVIEW ARTICLE

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Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials

Cited by 148 publications

References 42 publications

The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial

Possibilities of Correction and Prophylaxis of Intestinal Microbiocenosis Disorders in Frequently Ill Children

O papel dos probióticos e prebióticos na prática pediátrica

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